Provider Demographics
NPI:1760569792
Name:CLAWSON, SCOTT ALAN
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:ALAN
Last Name:CLAWSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 30TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-3209
Mailing Address - Country:US
Mailing Address - Phone:206-427-3947
Mailing Address - Fax:206-205-8044
Practice Address - Street 1:2124 4TH AVE
Practice Address - Street 2:ATTN: SCOTT CLAWSON
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-2308
Practice Address - Country:US
Practice Address - Phone:206-296-3119
Practice Address - Fax:206-205-8044
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA49370183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist