Active NPI
Suzanne Meradith Clanton, PSY.D.
- Clinical Psychologist
- Vancouver, WA
National Provider Identifier
1861553075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY00003853
- Practice address
- 1701 E Evergreen Blvd
Vancouver, WA 98661-4289 - Phone
- (503) 660-3106
- Fax
- (503) 747-7159
- NPI assigned
- Dec 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY00003853 | WA | Primary |
Addresses
Primary practice location
1701 E Evergreen Blvd
Vancouver, WA 98661-4289
Mailing address
PO Box 891
Beaverton, OR 97075-0891
Phone (503) 660-3106
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY00003853 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333324800000",
"number": "1861553075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 891",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970750891",
"telephone_number": "503-660-3106",
"fax_number": "503-747-7159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 E EVERGREEN BLVD",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986614289",
"telephone_number": "503-660-3106",
"fax_number": "503-747-7159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLANTON",
"first_name": "SUZANNE",
"middle_name": "MERADITH",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-12",
"last_updated": "2012-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY00003853",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.