Individual
RENEE CLAUSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1601 12TH AVE RD STE 101, NAMPA, ID 83686-6185
(208) 466-0200
Mailing address
1601 12TH AVE RD STE 101, NAMPA, ID 83686-6185
(208) 466-0200
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS2569
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MAS2569
MASSAGE BOARD
ID
Enumeration date
01/06/2023
Last updated
01/06/2023
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