Provider Demographics
NPI:1578861050
Name:CLASEN, CLAIRE M (RPH)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:M
Last Name:CLASEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 GEORGE WASHINGTON MEM HWY
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:VA
Mailing Address - Zip Code:23692-2764
Mailing Address - Country:US
Mailing Address - Phone:757-898-5466
Mailing Address - Fax:
Practice Address - Street 1:5500 GEORGE WASHINGTON MEM HWY
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:VA
Practice Address - Zip Code:23692-2764
Practice Address - Country:US
Practice Address - Phone:757-898-5466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-07
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202006485183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist