Provider Demographics
NPI:1487866968
Name:RONEY, CLAIRE SMITH (PHD)
Entity Type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:SMITH
Last Name:RONEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:CLAIRE
Other - Middle Name:MARIA
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:905 HIDDEN TRAIL RD
Mailing Address - Street 2:P.O.BOX 1611
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-9602
Mailing Address - Country:US
Mailing Address - Phone:360-379-5754
Mailing Address - Fax:
Practice Address - Street 1:905 HIDDEN TRAIL RD
Practice Address - Street 2:
Practice Address - City:PORT TOWNSEND
Practice Address - State:WA
Practice Address - Zip Code:98368-9602
Practice Address - Country:US
Practice Address - Phone:360-379-5754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY0001864103T00000X
OR1108103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7077795Medicaid
WA8802268Medicare ID - Type Unspecified