Provider Demographics
NPI:1780837690
Name:SATTERFIELD, CLAYTON DOUGLAS (ARNP)
Entity Type:Individual
Prefix:
First Name:CLAYTON
Middle Name:DOUGLAS
Last Name:SATTERFIELD
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15214 CANYON RD E STE 120
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98375-7472
Mailing Address - Country:US
Mailing Address - Phone:253-539-4200
Mailing Address - Fax:253-539-6005
Practice Address - Street 1:15214 CANYON RD E STE 120
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98375-7472
Practice Address - Country:US
Practice Address - Phone:253-539-4200
Practice Address - Fax:253-539-6005
Is Sole Proprietor?:No
Enumeration Date:2008-10-23
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60031350363LF0000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0242220OtherSTATE L&I
WA0242222OtherSTATE L&I
WA0261986OtherSTATE L&I
WA0242221OtherSTATE L&I
WA0242220OtherSTATE L&I
WAG8877049Medicare PIN