Provider Demographics
NPI:1356437172
Name:YORK, CLARE ELIZABETH (MPAS, PA-C)
Entity type:Individual
Prefix:MISS
First Name:CLARE
Middle Name:ELIZABETH
Last Name:YORK
Suffix:
Gender:F
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 S. DAISY ST.
Mailing Address - Street 2:
Mailing Address - City:SALMON
Mailing Address - State:ID
Mailing Address - Zip Code:83467
Mailing Address - Country:US
Mailing Address - Phone:208-756-6212
Mailing Address - Fax:208-756-6336
Practice Address - Street 1:805 MAIN ST.
Practice Address - Street 2:
Practice Address - City:SALMON
Practice Address - State:ID
Practice Address - Zip Code:83467
Practice Address - Country:US
Practice Address - Phone:208-756-6212
Practice Address - Fax:208-756-6336
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA 15564363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical