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Individual

JESSICA CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2575 WESTGATE BLDG 2, PENDLETON, OR 97801-9613
(541) 240-8030
(541) 429-8777
Mailing address
2575 WESTGATE BLDG 2, PENDLETON, OR 97801-9613
(541) 240-8030
(541) 429-8777

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
02/24/2016
Last updated
02/24/2016
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