GEOFFREY WAYNE CLARK

PORTLAND, OR
NPI1790751600
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: OR  AT-AT-908663)
Enumeration Date2006-02-28
Last Update Date2007-07-08
Business Address
Mr. GEOFFREY WAYNE CLARK ATC
7325 SW CHILDS RD
PORTLAND, OR 97224-7713
Phone number: 503-797-9812
Mailing Address
Mr. GEOFFREY WAYNE CLARK ATC
7325 SW CHILDS RD
PORTLAND, OR 97224-7713
Phone number: 503-797-9812
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