Individual
KATIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 E 4TH PLAIN BLVD, VANCOUVER, WA 98661-3713
(240) 577-4898
Mailing address
1511 SW 13TH AVE APT I354, BATTLE GROUND, WA 98604-2964
(240) 577-4898
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/03/2019
Last updated
07/03/2019
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