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1063451193
JEFFREY M CLARK
VANCOUVER, WA
NPI
1063451193
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: WA PA10002763)
Enumeration Date
2006-06-05
Last Update Date
2012-09-26
Business Address
-- JEFFREY M CLARK PA-C
600 NE 92ND AVE
VANCOUVER, WA 98664-3225
Phone number: 360-514-2142
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Mailing Address
-- JEFFREY M CLARK PA-C
FILE 742997
LOS ANGELES, CA 90074-2997
Phone number: 360-514-2142
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