Healthcare Provider Details

I. General information

NPI: 1336466234
Provider Name (Legal Business Name): CLAIRE T STOCKHAUSEN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2010
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 EASTLAKE AVE E
SEATTLE WA
98109-4405
US

IV. Provider business mailing address

700 CECIL ST
DURHAM NC
27707-3255
US

V. Phone/Fax

Practice location:
  • Phone: 206-288-1000
  • Fax:
Mailing address:
  • Phone: 919-530-7666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA60435765
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number2435-23
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: