Provider Demographics
NPI:1376736132
Name:KLAUSMEYER, KELSEY DEAN (ND, LMP)
Entity Type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:DEAN
Last Name:KLAUSMEYER
Suffix:
Gender:M
Credentials:ND, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 E JEFFERSON ST
Mailing Address - Street 2:SUITE 603
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5698
Mailing Address - Country:US
Mailing Address - Phone:206-726-0034
Mailing Address - Fax:206-726-9434
Practice Address - Street 1:1600 E JEFFERSON ST
Practice Address - Street 2:SUITE 603
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5698
Practice Address - Country:US
Practice Address - Phone:206-726-0034
Practice Address - Fax:206-726-9434
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024264174400000X
WANT60248492175F00000X
KS21-00029175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA00024264OtherLMP