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1982277703
CLINTON JAMES FORISKA
TACOMA, WA
NPI
1982277703
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-07-20
Last Update Date
2022-04-23
Business Address
CLINTON JAMES FORISKA DO
521 MARTIN LUTHER KING JR WAY
TACOMA, WA 98405-4238
Phone number: 253-792-6680
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Mailing Address
CLINTON JAMES FORISKA DO
101 RAINBOW WAY UNIT B
KELSO, WA 98626-2046
Phone number:
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