Individual
DR. CHRISTOPHER INMAN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
100 4TH AVE N, SUITE 145, SEATTLE, WA 98109-4905
(206) 728-7505
Mailing address
100 4TH AVE N, SUITE 145, SEATTLE, WA 98109-4905
(206) 728-7505
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00003035TX
WA
152WP0200X
Pediatric Optometrist
OD00003035TX
WA
152WS0006X
Sports Vision Optometrist
OD00003035TX
WA
152WV0400X
Vision Therapy Optometrist
OD00003035TX
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
143253
WA DEPT OF LABOR & INDUST
WA
01
—
CL4555
REGENCE WA HEALTH
WA
Enumeration date
06/30/2006
Last updated
05/21/2008
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