Provider Demographics
NPI:1912326778
Name:CLAUSSEN, DAN
Entity Type:Individual
Prefix:
First Name:DAN
Middle Name:
Last Name:CLAUSSEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1105
Mailing Address - Street 2:
Mailing Address - City:DUVALL
Mailing Address - State:WA
Mailing Address - Zip Code:98019-1105
Mailing Address - Country:US
Mailing Address - Phone:425-200-0130
Mailing Address - Fax:
Practice Address - Street 1:15315 NE 1ST AVE NE
Practice Address - Street 2:SUITE 205-A
Practice Address - City:DUVALL
Practice Address - State:WA
Practice Address - Zip Code:98019
Practice Address - Country:US
Practice Address - Phone:425-200-0130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist