Provider Demographics
NPI:1902616550
Name:ST MARIE, CLAIRE ELIZABETH
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:ELIZABETH
Last Name:ST MARIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3580 SE 82ND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97266-2902
Mailing Address - Country:US
Mailing Address - Phone:971-339-9240
Mailing Address - Fax:503-983-9899
Practice Address - Street 1:3580 SE 82ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97266-2902
Practice Address - Country:US
Practice Address - Phone:971-339-9240
Practice Address - Fax:503-983-9899
Is Sole Proprietor?:No
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR20201839RN163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)