Individual
JOHN B CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98431-0001
(253) 968-1250
Mailing address
9040 JACKSON AVE, TACOMA, WA 98431-0001
(253) 968-1250
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0101283147
VA
Other
Enumeration date
02/21/2023
Last updated
09/29/2024
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