Provider Demographics
NPI:1295863751
Name:CALVERT, BARCLAY CRAGIN (LAC)
Entity Type:Individual
Prefix:MR
First Name:BARCLAY
Middle Name:CRAGIN
Last Name:CALVERT
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:843 TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-5531
Mailing Address - Country:US
Mailing Address - Phone:360-316-9431
Mailing Address - Fax:
Practice Address - Street 1:1334 LAWRENCE ST
Practice Address - Street 2:
Practice Address - City:PORT TOWNSEND
Practice Address - State:WA
Practice Address - Zip Code:98368-6529
Practice Address - Country:US
Practice Address - Phone:360-379-6798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002627171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist