Provider Demographics
NPI:1023432655
Name:TILLEY, CLAIRE (DNP, MN)
Entity type:Individual
Prefix:MS
First Name:CLAIRE
Middle Name:
Last Name:TILLEY
Suffix:
Gender:F
Credentials:DNP, MN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5231 BRASSFIELD DR SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-4709
Mailing Address - Country:US
Mailing Address - Phone:781-801-4521
Mailing Address - Fax:206-385-4678
Practice Address - Street 1:5231 BRASSFIELD DR SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-4709
Practice Address - Country:US
Practice Address - Phone:781-801-4521
Practice Address - Fax:206-385-4678
Is Sole Proprietor?:No
Enumeration Date:2014-02-18
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60235841163WP0808X
WAAP60451844363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health