GARY DON CLINE (NPI# 1659462448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659462448 |
| Entity Type | Individual |
| Full Name | GARY DON CLINE |
| Credential | PAC |
| Practice Address |
4011 Talbot Rd S Suite 500 Renton WA 98055-5773 |
| Practice Telephone | 4252515110 |
| Practice Fax Number | 4257937376 |
| Mailing Telephone | 4252515110 |
| Mailing Fax Number | 4257937376 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2014-08-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
PA506 | ID | Allopathic & Osteopathic Physicians |
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
PA10002668 | WA | Allopathic & Osteopathic Physicians |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA10002668 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 8373383 | 05 | |
| REGENCE BLUE SHIELD OF ID | 000010143887 | 01 | |
| ID | 805004000 | 05 |
| Street Address |
4011 TALBOT RD S SUITE 500 |
| City | RENTON |
| State | WA |
| Zip Code | 98055-5773 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528061694 | Guy V Buell | Specialist | 4011 Talbot Rd S, Ste 440, Renton, WA 98055-5791 | 2005-05-23 |
| 1649756883 | Amy Elizabeth Hardiman | Physical Therapy Assistant | 4011 Talbot Rd S, Renton, WA 98055-5773 | 2018-07-11 |
| 1336665959 | Mary Elizabeth Walton | Dietitian, Registered | 4011 Talbot Rd S, Renton, WA 98055-5773 | 2017-08-15 |
| 1548791924 | Southlake Select, PC | Point of Service | 4011 Talbot Rd S, 440, Renton, WA 98055-5773 | 2017-03-27 |
| 1871031864 | Abrey Lee | Dietitian, Registered | 4011 Talbot Rd S, Suite 100, Renton, WA 98055-5773 | 2017-02-09 |
| 1962940957 | Kimberly Diana Konczak | Dietitian, Registered | 4011 Talbot Rd S, Suite 100, Renton, WA 98055-5773 | 2017-02-09 |
| 1578931325 | Andrew S Huntley | Physician Assistant | 4011 Talbot Rd S, Suite 300, Renton, WA 98055-5773 | 2015-09-10 |
| 1285011080 | Anne Macleod | Registered Nurse | 4011 Talbot Rd S, Renton, WA 98055-5773 | 2015-04-30 |
| 1508263716 | Mie Hagiwara | Physician Assistant | 4011 Talbot Rd S, Suite 300, Renton, WA 98055-5773 | 2014-12-03 |
| 1073921813 | Zachary A. Bowman | Physician Assistant | 4011 Talbot Rd S, Suite 300, Renton, WA 98055-5773 | 2014-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356965750 | Proliance Surgery Center At Valley, LLC | Clinic/Center | 4009 Talbot Road S, Suite 200, Renton, WA 98055 | 2020-06-01 |
| 1851804959 | Talbot Rehabilitation Center, LLC | Skilled Nursing Facility | 4430 Talbot Road South, Renton, WA 98055 | 2017-11-10 |
| 1154878668 | Nelson Family Dentistry | Dentist | 19221 108th Ave Se Suite #2, Renton, WA 98055 | 2016-09-01 |
| 1598182990 | Annie Kyunga Ahn | Otolaryngology | 4033 Talbot Rd S Ste 540, Renton, WA 98055 | 2014-03-24 |
| 1376960138 | Madhuri Gordhan Patel | Registered Nurse | 3501 Mill Place South, Renton, WA 98055 | 2014-03-18 |
| 1912331042 | Karen Dohr | Pharmacist | 400 S. 43 Street, Renton, WA 98055 | 2013-08-26 |
| 1659637668 | Benjamin Reiss | Ophthalmology | 4300 Talbot Rd S Ste 300, Renton, WA 98055 | 2012-04-03 |
| 1205137940 | Duy Ai Quang Hoang | Pharmacist | 9431 S 196th Pl, Renton, WA 98055 | 2010-11-11 |
| 1972823664 | Erica L Ellzey | Physical Therapist | 18623 112th Ave Se, Renton, WA 98055 | 2010-06-04 |
| 1588984587 | Melissa A. Jordan | Nurse Anesthetist, Certified Registered | 4011 Talbot Rd., 5th Floor, Renton, WA 98055 | 2010-06-02 |
| Find all providers in zip 98055 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962422956 | Charles J Davis | Physician Assistant | 14410 Se Petrovitsky Rd Ste 104, Renton, WA 98058-8900 | 2006-07-20 |
| 1255365219 | Gretchen Paige Wix | Physician Assistant | 800 Logan Ave N, Building 4-04, Medical, Renton, WA 98055-2080 | 2006-07-10 |
| 1649227380 | Public Hospital District #1 of King County | Physician Assistant | 14410 Se Petrovitsky Rd, Suite 104, Renton, WA 98058-8900 | 2006-05-28 |
| 1124075205 | Audra Jo Burdulis | Physician Assistant | 3600 Lind Ave Sw Ste 170, Renton, WA 98057-4934 | 2006-05-27 |
| 1154804854 | Alexandra Hurtado Dammen | Physician Assistant | 400 S 43rd St, Renton, WA 98055-5714 | 2018-09-10 |
| 1679018063 | Lindsey Paige O'donnell | Physician Assistant | 10555 Se Carr Rd, Bldg M, Renton, WA 98055-5820 | 2016-12-21 |
| 1437521655 | Marion Rose Larson | Physician Assistant | 707 S Grady Way Ste 600, Renton, WA 98057-3227 | 2015-10-27 |
| 1780989210 | Ashley Lorene Miguel | Physician Assistant | 350 S 38th Ct, Ste 115, Renton, WA 98055-5777 | 2011-01-13 |
| 1477888592 | Cheryl Lefler Cieszlak | Physician Assistant | 4033 Talbot Rd S, Ste 530, Renton, WA 98055-5772 | 2009-10-07 |
| 1700031861 | Dwayne Eric Hammond | Physician Assistant | 500 Sw 39th St, Suite 150, Renton, WA 98057-4915 | 2008-11-17 |
| Find all providers in RENTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.