Provider Demographics
NPI:1326131806
Name:REIDY, CLARE MARGUERITE (MD)
Entity Type:Individual
Prefix:DR
First Name:CLARE
Middle Name:MARGUERITE
Last Name:REIDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CLARE
Other - Middle Name:MARGUERITE
Other - Last Name:MCCLUGGAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10407 NE 70TH CT
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98686-3805
Mailing Address - Country:US
Mailing Address - Phone:360-609-3686
Mailing Address - Fax:
Practice Address - Street 1:7101 NE 137TH AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98682-4933
Practice Address - Country:US
Practice Address - Phone:800-813-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00045976207Q00000X
TXG9158207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine