Provider Demographics
NPI:1942473244
Name:RICHARDS, CLAIRE (CHA IV)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:CHA IV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3380 C ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-3949
Mailing Address - Country:US
Mailing Address - Phone:907-277-1440
Mailing Address - Fax:907-277-1446
Practice Address - Street 1:49 MAIN ST.
Practice Address - Street 2:
Practice Address - City:FALSE PASS
Practice Address - State:AK
Practice Address - Zip Code:99583
Practice Address - Country:US
Practice Address - Phone:907-548-2742
Practice Address - Fax:907-548-2247
Is Sole Proprietor?:No
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMDG923Medicaid