Provider Demographics
NPI:1568600435
Name:CLAUSEN, NATALIE (LIC AC)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:CLAUSEN
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 WALL ST
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84103-1752
Mailing Address - Country:US
Mailing Address - Phone:801-359-2705
Mailing Address - Fax:
Practice Address - Street 1:421 WALL ST
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84103-1752
Practice Address - Country:US
Practice Address - Phone:801-359-2705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-29
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT100931-1201171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist