Individual
DR. ANNE W CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
9000 N LOMBARD ST, PORTLAND, OR 97203-3006
(503) 988-5304
(503) 988-5305
Mailing address
421 SW OAK ST, STE.210, PORTLAND, OR 97204-1817
(503) 988-7468
(503) 988-3015
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1941
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022959
—
OR
05
—
096511
—
OR
Enumeration date
12/18/2009
Last updated
04/06/2016
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