Provider Demographics
NPI:1992758312
Name:JANSSEN, CLAUS HENNER (MD)
Entity type:Individual
Prefix:
First Name:CLAUS
Middle Name:HENNER
Last Name:JANSSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 SHERIDAN ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-2901
Mailing Address - Country:US
Mailing Address - Phone:360-385-3500
Mailing Address - Fax:360-385-5496
Practice Address - Street 1:1010 SHERIDAN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:PORT TOWNSEND
Practice Address - State:WA
Practice Address - Zip Code:98368-2901
Practice Address - Country:US
Practice Address - Phone:360-385-3500
Practice Address - Fax:360-385-5496
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00031036207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1084391Medicaid
WAGAB38203Medicare ID - Type Unspecified
WA1084391Medicaid