Provider Demographics
NPI:1447287289
Name:MCLEMORE, CYNTHIA ELIZABETH (ARNP)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ELIZABETH
Last Name:MCLEMORE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:E
Other - Last Name:OLOFSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:34520 16TH AVE S
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6802
Mailing Address - Country:US
Mailing Address - Phone:253-838-1500
Mailing Address - Fax:
Practice Address - Street 1:34520 16TH AVE S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6802
Practice Address - Country:US
Practice Address - Phone:253-838-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC601171100000X
WAAP30006002363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No171100000XOther Service ProvidersAcupuncturist