Individual
DR. CLAUDIA KATHERINE LAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
228 NW B ST, UPPER UNIT, GRANTS PASS, OR 97526-2032
(541) 761-6764
(541) 592-6479
Mailing address
PO BOX 1665, CAVE JUNCTION, OR 97523-1665
(541) 761-6764
(541) 592-6479
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2322
OR
103TC0700X
Clinical Psychologist
PSY 16678
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376345448
NPI
—
Enumeration date
06/01/2007
Last updated
08/18/2014
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