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1134694953
JIM CLARK
LACEY, WA
NPI
1134694953
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
(Licence: WA SC60907499)
Enumeration Date
2018-10-08
Last Update Date
2018-12-19
Business Address
JIM CLARK
612 WOODLAND SQUARE LOOP SE STE 401
LACEY, WA 98503-1070
Phone number: 360-763-5828
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Mailing Address
JIM CLARK
7529 BRIANNA CT SE
OLYMPIA, WA 98513-5302
Phone number: 253-315-5124
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