Individual
KERRY R CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
101 W 8TH AVE, SUITE 1100, SPOKANE, WA 99204-2307
(509) 474-4060
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI00000348
WA
Other
Enumeration date
06/21/2013
Last updated
05/03/2021
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