Provider Demographics
NPI:1306595988
Name:SEABORNE, CLEMIANA
Entity type:Individual
Prefix:
First Name:CLEMIANA
Middle Name:
Last Name:SEABORNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 DOWNING ST NE APT 5
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-3420
Mailing Address - Country:US
Mailing Address - Phone:202-902-3650
Mailing Address - Fax:
Practice Address - Street 1:1414 DOWNING ST NE APT 5
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-3420
Practice Address - Country:US
Practice Address - Phone:202-902-3650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17012-163-226-9699246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy