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1154061711
ELLEN CLARK
PORTLAND, OR
NPI
1154061711
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2022-03-31
Last Update Date
2022-03-31
Business Address
ELLEN CLARK MD
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3011
Phone number: 503-494-8607
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Mailing Address
ELLEN CLARK MD
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3098
Phone number: 503-494-8211
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