MEDICARE: MR. DONALD CLIFTON LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LH60474619	WA

General Provider Information

NPI Number	:	1871008847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DONALD CLIFTON LMHC

Provider Business Mailing Address
First Line	:	707 N 130TH ST APT B201
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98133-7962
Country	:	US
Telephone Number	:	206-380-3248
Fax Number	:

Provider Business Practice Location Address
First Line	:	7900 E GREEN LAKE DR N STE 202
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-4818
Country	:	US
Telephone Number	:	918-558-4243
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2017
Last Update Date	:	12/12/2017

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