Provider Demographics
NPI:1811066483
Name:HELTON, CLARISSA LENORE (LAC)
Entity type:Individual
Prefix:
First Name:CLARISSA
Middle Name:LENORE
Last Name:HELTON
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3012 S DAWSON ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-2123
Mailing Address - Country:US
Mailing Address - Phone:206-282-5386
Mailing Address - Fax:
Practice Address - Street 1:600 W MCGRAW ST
Practice Address - Street 2:SUITE 1
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-5801
Practice Address - Country:US
Practice Address - Phone:206-282-5386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002816171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist