Provider Demographics
NPI:1225099260
Name:CLABOTS, JOSEPH P (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:P
Last Name:CLABOTS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7424 BRIDGEPORT WAY W
Mailing Address - Street 2:SUITE 307
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-8120
Mailing Address - Country:US
Mailing Address - Phone:253-588-3149
Mailing Address - Fax:253-588-2688
Practice Address - Street 1:7424 BRIDGEPORT WAY W
Practice Address - Street 2:SUITE 307
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-8120
Practice Address - Country:US
Practice Address - Phone:253-588-3149
Practice Address - Fax:253-588-2688
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00023513208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1012582Medicaid
WA1001572Medicare ID - Type Unspecified
WA1012582Medicaid