Individual
MARK W CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
7507 NE 51ST ST, VANCOUVER, WA 98662-6007
(360) 906-1190
(360) 906-1193
Mailing address
PO BOX 82819, PORTLAND, OR 97282-0819
(503) 233-5405
(503) 233-2696
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY2226
WA
103TC0700X
Clinical Psychologist
PY2226
WA
103TF0200X
Forensic Psychologist
Primary
PY2226
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164936
—
OR
Enumeration date
12/20/2006
Last updated
03/13/2026
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