Individual
BECKY ANN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S., P.T.
Contact information
Practice address
12012 E MISSION AVE, SPOKANE VALLEY, WA 99206-4887
(509) 413-1630
(509) 413-1673
Mailing address
21525 N LITTLE SPOKANE DR, COLBERT, WA 99005-9478
(509) 466-1850
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00000849
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0108459
LABOR & INDUSTRIES
WA
05
—
7076995
—
WA
Enumeration date
03/23/2006
Last updated
04/09/2012
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