Provider Demographics
NPI:1174794267
Name:PATRICK H MCCLEAN
Entity type:Organization
Organization Name:PATRICK H MCCLEAN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:H
Authorized Official - Last Name:MCCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-242-3696
Mailing Address - Street 1:16259 SYLVESTER RD SW
Mailing Address - Street 2:SUITE #505
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-3049
Mailing Address - Country:US
Mailing Address - Phone:206-242-3696
Mailing Address - Fax:206-246-1078
Practice Address - Street 1:16259 SYLVESTER RD SW
Practice Address - Street 2:SUITE #505
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-3049
Practice Address - Country:US
Practice Address - Phone:206-242-3696
Practice Address - Fax:206-246-1078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAD33727Medicare UPIN
WAG8802014Medicare PIN