Individual
EMILY JUNE PUUKKA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
18040 SW LOWER BOONES FERRY RD, STE 100, TIGARD, OR 97224-7258
(503) 216-0700
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
LL18426
OR
207Q00000X
Family Medicine Physician
Primary
MD157668
OR
Other
Enumeration date
06/08/2009
Last updated
10/13/2020
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