Healthcare Provider Details

I. General information

NPI: 1467378380
Provider Name (Legal Business Name): ACACIA TERESA CLAUSING PSS,YSS,CRM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 GARDEN AVE
KLAMATH FALLS OR
97601-3448
US

IV. Provider business mailing address

2201 GARDEN AVE
KLAMATH FALLS OR
97601-3448
US

V. Phone/Fax

Practice location:
  • Phone: 707-951-0193
  • Fax:
Mailing address:
  • Phone: 707-951-0193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number26-CRM-5587
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: