Individual
MRS. JUDY GOODROAD CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
93893 LEEHMANN LN, LAKEVIEW, OR 97630-9003
(541) 947-4010
Mailing address
93893 LEEHMANN LN, LAKEVIEW, OR 97630-9003
(541) 947-4010
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
088003027RN
OR
Other
Enumeration date
02/05/2010
Last updated
02/05/2010
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