Provider Demographics
NPI:1578935581
Name:CLAWSON, BETHANY A (PA-C)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:A
Last Name:CLAWSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 CALIFORNIA ST STE 601
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-3721
Mailing Address - Country:US
Mailing Address - Phone:720-778-0005
Mailing Address - Fax:
Practice Address - Street 1:1615 CALIFORNIA ST STE 601
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-3721
Practice Address - Country:US
Practice Address - Phone:720-778-0005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-29
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant