Provider Demographics
NPI:1861757049
Name:CLAUSSEN, BRANDIE LEE (LMP)
Entity type:Individual
Prefix:MS
First Name:BRANDIE
Middle Name:LEE
Last Name:CLAUSSEN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 S SOUTHEAST BLVD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-2570
Mailing Address - Country:US
Mailing Address - Phone:509-536-1620
Mailing Address - Fax:
Practice Address - Street 1:1312 S SOUTHEAST BLVD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-2570
Practice Address - Country:US
Practice Address - Phone:509-536-1620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60279634225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist