DR. DONALD W CLELAND DNP, CNP
Complete NPI Record 1417159849
Nurse Practitioner - Psychiatric/Mental Health in Everett, WA
Active since June 05, 2007PECOS EnrolledAccepts Medicare Assignment
Complete NPI Dataset
This page contains the complete raw NPPES record for Dr. Donald W Cleland, DNP, CNP (NPI 1417159849), an individual nurse practitioner provider in Everett, WA. All 42 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, Markdown or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1417159849 Field 1/42
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 1 Field 2/42
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Provider Last Name Legal Name: CLELAND Field 3/42
- The last name of the provider. If the provider is an individual, this is the legal name.
- Provider First Name: DONALD Field 4/42
- The first name of the provider, if the provider is an individual.
- Provider Middle Name: W Field 5/42
- The middle name of the provider, if the provider is an individual.
- Provider Name Prefix Text: DR. Field 6/42
- The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
- Provider Credential Text: DNP, CNP Field 7/42
- The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
- Provider First Line Business Mailing Address: 620 SW 5TH AVE STE 900 Field 8/42
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Second Line Business Mailing Address: PMB 154 Field 9/42
- The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
- Provider Business Mailing Address City Name: PORTLAND Field 10/42
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: OR Field 11/42
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 972041431 Field 12/42
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 13/42
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 4582504964 Field 14/42
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 4582506817 Field 15/42
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 2804 GRAND AVE STE 300D Field 16/42
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: EVERETT Field 17/42
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: WA Field 18/42
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 982013586 Field 19/42
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 20/42
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 4582504964 Field 21/42
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 4582506817 Field 22/42
- The fax number associated with the location address of the provider being identified.
- Provider Gender Code: M Field 25/42
- The code designating the provider's gender if the provider is a person.
- Healthcare Provider Taxonomy Code 1: 363LF0000X Field 26/42
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 1: 202100768NPPP Field 27/42
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 1: OR Field 28/42
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: N Field 29/42
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 2: 363LP0808X Field 30/42
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 2: AP61186015 Field 31/42
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 2: WA Field 32/42
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 2: N Field 33/42
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 3: 363LP0808X Field 34/42
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 3: 202100768NPPP Field 35/42
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 3: OR Field 36/42
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 3: Y Field 37/42
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Other Provider Identifier 1: 500855263 Field 38/42
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 1: 05 Field 39/42
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 1: OR Field 40/42
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Is Sole Proprietor: N Field 41/42
- Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
Secondary Practice Locations 14
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
6230 Jack Hill Dr
Location 1/14Oroville, CA 95966-3855 · Phone (530) 518-8923
1742 Oregon St
Location 2/14Redding, CA 96001-1717 · Phone (530) 221-7474 · Fax (530) 226-6329
1311 11th St
Location 3/14Reedley, CA 93654-2926 · Phone (855) 343-1057 · Fax (844) 587-6408
2891 Churn Creek Rd
Location 4/14Redding, CA 96002 · Phone (530) 221-7474
3400 McCall Ave
Location 5/14Selma, CA 93662-4165 · Phone (855) 343-1057 · Fax (844) 566-2683
275 S Madera Ave Ste 404
Location 6/14Kerman, CA 93630-1401 · Phone (855) 343-1057 · Fax (844) 566-1387
40 E Minarets Ave
Location 7/14Pinedale, CA 93650-1239 · Phone (855) 343-1057 · Fax (844) 587-6405
121 Belmont Ave
Location 8/14Mendota, CA 93640-8232 · Phone (855) 343-1057
380 Coalinga Plz
Location 9/14Coalinga, CA 93210-1704 · Phone (855) 343-1057 · Fax (844) 563-6078
36618 Lassen Ave, Ste A
Location 10/14Huron, CA 93234 · Phone (855) 343-1057 · Fax (844) 230-8561
225 Academy Ave
Location 11/14Sanger, CA 93657-2128 · Phone (855) 343-1057 · Fax (844) 587-6403
376 Vallombrosa Ave
Location 12/14Chico, CA 95926-3900 · Phone (530) 891-1676 · Fax (530) 891-1833
175 W B St
Location 13/14Springfield, OR 97477-4575 · Phone (458) 250-4964 · Fax (458) 250-6817
175 W B St Bldg K2
Location 14/14Springfield, OR 97477-4575 · Phone (458) 250-4964 · Fax (458) 250-6817
Other Provider Identifiers 1
Legacy and payer-issued identifiers reported to the NPPES registry for this provider.
500855263 Medicaid
Identifier 1/1State: OR
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
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