Provider Demographics
NPI:1477982601
Name:BEAR, CLARE P
Entity Type:Individual
Prefix:
First Name:CLARE
Middle Name:P
Last Name:BEAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 421
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-0421
Mailing Address - Country:US
Mailing Address - Phone:509-474-3568
Mailing Address - Fax:509-227-7070
Practice Address - Street 1:820 S MCCLELLAN ST STE 200
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2456
Practice Address - Country:US
Practice Address - Phone:509-747-1144
Practice Address - Fax:509-227-7070
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2021-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60419705101YM0800X
WA606138411041C0700X
WALW608832111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7138407796Medicaid