Provider Demographics
NPI:1316132731
Name:CLEARVIEW CLINIC
Entity type:Organization
Organization Name:CLEARVIEW CLINIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:HUNHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:425-481-8811
Mailing Address - Street 1:18122 SR 9 SE
Mailing Address - Street 2:SUITE B
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296-5384
Mailing Address - Country:US
Mailing Address - Phone:425-481-8811
Mailing Address - Fax:425-486-7427
Practice Address - Street 1:18122 SR 9 SE
Practice Address - Street 2:SUITE B
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98296-5384
Practice Address - Country:US
Practice Address - Phone:425-481-8811
Practice Address - Fax:425-486-7427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAR01054OtherREGENCE
WA7003544Medicaid
WAR01054OtherREGENCE BLUE SHIELD
PA6ZGW-00OtherOHP IDENTIFIER
WAR01054OtherREGENCE BLUE SHIELD