Provider Demographics
NPI:1891973087
Name:WORJOLOH-CLEMENS, AYABA G (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:AYABA
Middle Name:G
Last Name:WORJOLOH-CLEMENS
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:AYABA
Other - Middle Name:G
Other - Last Name:WORJOLOH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 5127
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98206-5127
Mailing Address - Country:US
Mailing Address - Phone:425-339-5430
Mailing Address - Fax:
Practice Address - Street 1:900 PACIFIC AVE STE 500
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4189
Practice Address - Country:US
Practice Address - Phone:425-339-5430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-10
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102607207V00000X
WAMD60621129207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2057294Medicaid
WAG8952149Medicare PIN
WA2057294Medicaid