Patricia A. Clement, R.D., C.D., C.D.E.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DI00001084 Issued in WA

Practice address

19930 Ballinger Way NE
Shoreline, WA 98155-1223

Phone

(425) 778-2220

NPI assigned

Dec 13, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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

• Puget Sound Surgical Clinic Inc

  • Ambulatory Surgical Clinic/Center
  • Shoreline, WA
  • NPI 1689814998
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1184785990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21911 76TH AVE W",
            "address_2": "SUITE 106",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267918",
            "telephone_number": "425-778-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19930 BALLINGER WAY NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981551223",
            "telephone_number": "425-778-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENT",
        "first_name": "PATRICIA",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "R.D., C.D., C.D.E.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI00001084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RD CERTIFICATION",
            "identifier": "699275",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "DI00001084",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Faith Claggett
• Julee P. Clark, M.A. , L.M.F.T.
• Karen Edith Clark, PH.D.
• Ciara Michele Cleary
• Erin Marie Cleary, LMT
• Brian Keith Clute, PT
• Princeton L Co, D.D.S.
• Andy Coate
• Christine M. Coble, OT
• Sunoma Codispoti, COTA/L

• Registered Dietitian in Shoreline, WA
• Providers in Shoreline, WA by specialty
• Registered Dietitian in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; 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.