Gary Don Cline, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA10002668 Issued in WA

Practice address

4011 Talbot Rd S
Suite 500
Renton, WA 98055-5773

Phone

(425) 251-5110

Fax

(425) 793-7376

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Northwest Renal Services Inc

  • Nephrology Physician
  • Spokane, WA
  • NPI 1629291273
  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409270400000",
    "number": "1659462448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 TALBOT RD S",
            "address_2": "SUITE 500",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555773",
            "telephone_number": "425-251-5110",
            "fax_number": "425-793-7376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 TALBOT RD S",
            "address_2": "SUITE 500",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555773",
            "telephone_number": "425-251-5110",
            "fax_number": "425-793-7376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINE",
        "first_name": "GARY",
        "middle_name": "DON",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2014-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "PA10002668",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "ID",
            "license": "PA506",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10002668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8373383",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD OF ID",
            "identifier": "000010143887",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805004000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clearly Lasik, Inc.
• Margaret H Clements, MD
• Cleopatra Rejuvenation Clinic, PLLC
• Seth Clewley
• Joseph Christopher Clifton, PHARM.D.
• Close Knit Counseling, PLLC
• Cloudland Home Care LLC
• Kaitlyn Elizabeth Clugston, PT
• Judith Leslie Cohen, PH.D.
• Ronald Cohen

• Medical Physician Assistant in Renton, WA
• Providers in Renton, 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 Aug 29, 2014; 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.