Provider Demographics
NPI:1033382270
Name:NATHAN W. CLEM, CORP, PS
Entity Type:Organization
Organization Name:NATHAN W. CLEM, CORP, PS
Other - Org Name:DISCOVERY WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:CLEM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-283-7033
Mailing Address - Street 1:3655 34TH AVE W
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98199-1609
Mailing Address - Country:US
Mailing Address - Phone:206-283-7033
Mailing Address - Fax:206-283-8407
Practice Address - Street 1:3655 34TH AVE W
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98199-1609
Practice Address - Country:US
Practice Address - Phone:206-283-7033
Practice Address - Fax:206-283-8407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty