Provider Demographics
NPI:1285638635
Name:NOEL, CLARISSE E (MD)
Entity Type:Individual
Prefix:DR
First Name:CLARISSE
Middle Name:E
Last Name:NOEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 N 5TH AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-3045
Mailing Address - Country:US
Mailing Address - Phone:360-582-2690
Mailing Address - Fax:360-582-2691
Practice Address - Street 1:800 N 5TH AVE
Practice Address - Street 2:STE 101
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-3045
Practice Address - Country:US
Practice Address - Phone:360-582-2690
Practice Address - Fax:360-582-2691
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00041353207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0197263OtherWA LABOR & INDUSTRIES
WA0197263OtherWA LABOR & INDUSTRIES