Individual
CHARLES MICHAEL CLARK II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
6314 19TH ST W STE 7, FIRCREST, WA 98466-6223
(253) 201-6070
Mailing address
4404 PACIFIC ST SW, LAKEWOOD, WA 98499-4244
(253) 201-6070
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
WA
Other
Enumeration date
09/14/2015
Last updated
03/04/2021
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