Individual
DR. ROGER KEVIN CLARK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 418-3308
Mailing address
31192 SW WILLAMETTE WAY W, WILSONVILLE, OR 97070-8581
(503) 570-3436
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0011422
OR
Other
Enumeration date
09/19/2019
Last updated
09/19/2019
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