Provider Demographics
NPI:1679994966
Name:CLAUSON, JANE INGER (PT)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:INGER
Last Name:CLAUSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 821643
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-0038
Mailing Address - Country:US
Mailing Address - Phone:360-936-1557
Mailing Address - Fax:360-989-1219
Practice Address - Street 1:3305 MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663-2250
Practice Address - Country:US
Practice Address - Phone:360-936-1557
Practice Address - Fax:360-989-1219
Is Sole Proprietor?:No
Enumeration Date:2014-01-03
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT 00008376225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist