| NPI | 1700904778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE JEFFREY CLARK Owner Practitioner 425-255-0427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WA 2219) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2011-05-13 |