Individual
MISTY NOEL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2621 NE 134TH ST STE 140, VANCOUVER, WA 98686-3036
(360) 907-4351
Mailing address
PO BOX 321, LA CENTER, WA 98629-0321
(360) 907-4351
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
RN0011826
WA
Other
Enumeration date
11/20/2023
Last updated
11/21/2023
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