Provider Demographics
NPI:1548554652
Name:CLAUSEN, LEAH (PHARMD)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:CLAUSEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5405 MILLS CIVIC PKWY
Mailing Address - Street 2:T1901
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-5303
Mailing Address - Country:US
Mailing Address - Phone:515-223-3597
Mailing Address - Fax:515-223-3597
Practice Address - Street 1:5405 MILLS CIVIC PKWY
Practice Address - Street 2:T1901
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-5303
Practice Address - Country:US
Practice Address - Phone:515-223-3597
Practice Address - Fax:515-223-3597
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20938183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist