Provider Demographics
NPI:1700215134
Name:BROSTROM, CLAIRE (MSN RN)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:BROSTROM
Suffix:
Gender:F
Credentials:MSN RN
Other - Prefix:MRS
Other - First Name:CLAIRE
Other - Middle Name:MARIE
Other - Last Name:BROSTROM-SMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSN RN
Mailing Address - Street 1:13018 20TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-4122
Mailing Address - Country:US
Mailing Address - Phone:206-252-4307
Mailing Address - Fax:
Practice Address - Street 1:13018 20TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-4122
Practice Address - Country:US
Practice Address - Phone:206-252-4307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60283449163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool