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NPI Code Detail

MEDICARE: ARVILLA MARIE CLAUSSEN PMHNP

MEDICARE: ARVILLA MARIE CLAUSSEN PMHNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner000033310N6 PMHNP PPOR

General Provider Information

NPI Number : 1639244015
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARVILLA MARIE CLAUSSEN PMHNP
Provider Business Mailing Address
First Line : 2250 D ST NE
Second Line :
City : SALEM
State : OR
Zip : 97301-2768
Country : US
Telephone Number : 503-364-6093
Fax Number : 503-364-5121
Provider Business Practice Location Address
First Line : 2250 D ST NE
Second Line :
City : SALEM
State : OR
Zip : 97301-2768
Country : US
Telephone Number : 503-364-6093
Fax Number : 503-364-5121
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2006
Last Update Date : 07/08/2007

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