Provider Demographics
NPI:1053309286
Name:DELEON, CLARABEL (PA-C)
Entity type:Individual
Prefix:
First Name:CLARABEL
Middle Name:
Last Name:DELEON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 JUNE ST
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1516
Mailing Address - Country:US
Mailing Address - Phone:541-386-3626
Mailing Address - Fax:
Practice Address - Street 1:1021 JUNE ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1516
Practice Address - Country:US
Practice Address - Phone:541-386-3626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA00513363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR226813Medicaid
R115192Medicare PIN
S18102Medicare UPIN
R0000WCJGHMedicare PIN