Provider Demographics
NPI:1649466376
Name:SCOTT, CLARA O (PA-C)
Entity type:Individual
Prefix:
First Name:CLARA
Middle Name:O
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-0001
Mailing Address - Country:US
Mailing Address - Phone:253-968-2252
Mailing Address - Fax:
Practice Address - Street 1:MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-2795
Practice Address - Country:US
Practice Address - Phone:253-968-2252
Practice Address - Fax:706-327-1159
Is Sole Proprietor?:No
Enumeration Date:2007-09-17
Last Update Date:2022-11-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA005165363A00000X
WAPA10004520363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant