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1346868841
CLARK RANDALL
LONGVIEW, WA
NPI
1346868841
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: WA CG61088625)
Enumeration Date
2020-07-10
Last Update Date
2020-07-10
Business Address
CLARK RANDALL
748 14TH AVE
LONGVIEW, WA 98632-2315
Phone number: 360-200-5419
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Mailing Address
CLARK RANDALL
748 14TH AVE
LONGVIEW, WA 98632-2315
Phone number: 360-200-5419
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