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1801613344
MICHAEL ROY CLARK
PORTLAND, OR
NPI
1801613344
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
374700000X Technician
Enumeration Date
2024-09-25
Last Update Date
2024-09-25
Business Address
MICHAEL ROY CLARK
4212 SE DIVISION ST STE 100
PORTLAND, OR 97206-1680
Phone number: 503-238-0705
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Mailing Address
MICHAEL ROY CLARK
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number:
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