Provider Demographics
NPI:1972833929
Name:CLAUSSEN, CRYSTAL LYNN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:LYNN
Last Name:CLAUSSEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:LYNN
Other - Last Name:ROMERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4949 W CHANDLER BLVD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-7922
Mailing Address - Country:US
Mailing Address - Phone:480-592-9465
Mailing Address - Fax:
Practice Address - Street 1:4949 W CHANDLER BLVD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-7922
Practice Address - Country:US
Practice Address - Phone:480-592-9465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS017323183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist