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General NPI Number Information
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NPI Number | 1174884357
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Entity Type | Individual
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Provider Name | ERIC RAYMOND CLAUSELL PH.D.
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Gender | Male
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Dates
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Enumeration Date | 06/04/2012
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Last Update Date | 02/18/2015
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Provider Practice Location Address
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Address Line | 9600 VETERANS DRIVE 61-116-C
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City | TACOMA
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State | WA
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Zip | 98493
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Country | US
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Telephone | 253-583-2840
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Fax |
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Provider Business Mailing Address
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Address Line | 9600 VETERANS DR SW 61-116-C
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City | TACOMA
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State | WA
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Zip | 98493-0003
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Country | US
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Telephone | 253-583-2840
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY60331641
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License Number State | WA
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