Provider Demographics
NPI:1780612887
Name:MCCLEAN, STEVEN P (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:P
Last Name:MCCLEAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:4300 TALBOT RD S
Mailing Address - Street 2:310
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-6238
Mailing Address - Country:US
Mailing Address - Phone:425-228-3110
Mailing Address - Fax:425-226-4294
Practice Address - Street 1:4300 TALBOT RD S
Practice Address - Street 2:310
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-6238
Practice Address - Country:US
Practice Address - Phone:425-228-3110
Practice Address - Fax:425-226-4294
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00026177207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1069913Medicaid
WA030000889OtherRR MEDICARE
WAGAB37486Medicare PIN
WAB24708Medicare UPIN
WAG000109582Medicare PIN