Provider Demographics
NPI:1508893058
Name:CLAUSEL, JEFFREY L (PHD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:L
Last Name:CLAUSEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 MAIN ST
Mailing Address - Street 2:PO BOX 470
Mailing Address - City:BAKER CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97814-3465
Mailing Address - Country:US
Mailing Address - Phone:541-523-4715
Mailing Address - Fax:541-523-2628
Practice Address - Street 1:1705 MAIN ST, SUITE 501
Practice Address - Street 2:
Practice Address - City:BAKER CITY
Practice Address - State:OR
Practice Address - Zip Code:97814-3465
Practice Address - Country:US
Practice Address - Phone:541-523-4715
Practice Address - Fax:541-523-2628
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1400103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical