Debra Jean Clinton, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA10003293 Issued in WA

Practice address

850 West Maple Street
Medical Lake, WA 99022-0800

Phone

(509) 565-4000

NPI assigned

Apr 16, 2007

Last updated

Jun 17, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Department of Social

  dba Western State Hospital

  • Psychiatric Hospital
  • Tacoma, WA
  • NPI 1144295080
  NPD (past)
• Eastern State Hospital Pharmacy

  • Long Term Care Pharmacy
  • Medical Lake, WA
  • NPI 1679651970
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276732800000",
    "number": "1164647863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 WEST MAPLE STREET",
            "city": "MEDICAL LAKE",
            "state": "WA",
            "postal_code": "990220800",
            "telephone_number": "509-565-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 WEST MAPLE STREET",
            "city": "MEDICAL LAKE",
            "state": "WA",
            "postal_code": "990220800",
            "telephone_number": "509-565-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINTON",
        "first_name": "DEBRA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2010-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10003293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barry R Caparoso, M.D.
• Robert Castellaw
• Eric John Chase, PHARM.D
• Cheney Owl Pharmacy Inc (Medical Lake Owl Pharmacy)
• Lynee L Clay, RN
• Kimberly Cole, PSY. D.
• Compassion First Psychiatry PLLC
• Alton J Couturier, PHD
• Laura Cox, AGNP
• Thomas A. Crisp Jr., D.O.

• Medical Physician Assistant in Medical Lake, WA
• Providers in Medical Lake, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.