Provider Demographics
NPI:1720317738
Name:CLEMANS, ADAM LYNN (PHARMD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:LYNN
Last Name:CLEMANS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5512 E GREEN LAKE WAY N APT 3
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-5958
Mailing Address - Country:US
Mailing Address - Phone:206-681-6151
Mailing Address - Fax:
Practice Address - Street 1:5512 E GREEN LAKE WAY N APT 3
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-5958
Practice Address - Country:US
Practice Address - Phone:206-681-6151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-22
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60101820183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist