Provider Demographics
NPI:1851491955
Name:CLIPPARD, ASHLEY (PT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:CLIPPARD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1218 3RD AVE
Mailing Address - Street 2:STE 104
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-3008
Mailing Address - Country:US
Mailing Address - Phone:206-447-2220
Mailing Address - Fax:206-447-2228
Practice Address - Street 1:17694 1ST AVE S
Practice Address - Street 2:SUITE A
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98148-1729
Practice Address - Country:US
Practice Address - Phone:206-241-0477
Practice Address - Fax:206-241-0538
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT9880225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA200435OtherLABOR & INDUSTRIES
WA8433732Medicaid