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1659810299
TIMOTHY JOHN CLARK
PENDLETON, OR
NPI
1659810299
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
Additional Taxonomies
101Y00000X Counselor
Enumeration Date
2017-02-15
Last Update Date
2020-01-29
Business Address
TIMOTHY JOHN CLARK
17 SW FRAZER AVE STE 282
PENDLETON, OR 97801-0048
Phone number: 541-278-6330
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Mailing Address
TIMOTHY JOHN CLARK
17 SW FRAZER AVE STE 282
PENDLETON, OR 97801-0048
Phone number: 541-278-6330
Copy
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