Provider Demographics
NPI:1922289032
Name:DR JOSEPH PAUL CLABOTS
Entity Type:Organization
Organization Name:DR JOSEPH PAUL CLABOTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:CLABOTS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-588-3149
Mailing Address - Street 1:PO BOX 11073
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98411-0073
Mailing Address - Country:US
Mailing Address - Phone:253-588-3149
Mailing Address - Fax:253-588-2688
Practice Address - Street 1:7424 BRIDGEPORT WAY W STE 307
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-8135
Practice Address - Country:US
Practice Address - Phone:253-588-3149
Practice Address - Fax:253-588-2688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-16
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00023513208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1012582Medicaid
WAA08737OtherUPIN