Provider Demographics
NPI:1033810023
Name:CORSON, CLAIRE ELIZABETH (MS, RD, RDN)
Entity Type:Individual
Prefix:MS
First Name:CLAIRE
Middle Name:ELIZABETH
Last Name:CORSON
Suffix:
Gender:F
Credentials:MS, RD, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 E 17TH AVE APT 37
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4413
Mailing Address - Country:US
Mailing Address - Phone:321-205-6603
Mailing Address - Fax:
Practice Address - Street 1:735 E 17TH AVE APT 37
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4413
Practice Address - Country:US
Practice Address - Phone:321-205-6603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLD-D-10229594133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered