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1417483553
MACEY CLARK
LA GRANDE, OR
NPI
1417483553
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: OR 201241211RN)
Enumeration Date
2017-05-10
Last Update Date
2017-10-12
Business Address
MACEY CLARK CPNP-PC
710 SUNSET DR SUITE E
LA GRANDE, OR 97850-1200
Phone number: 541-962-5600
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Mailing Address
MACEY CLARK CPNP-PC
710 SUNSET DR SUITE E
LA GRANDE, OR 97850-1200
Phone number: 541-663-3150
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