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Individual

DR. CLARENCE HAROLD MIELKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
25415 E MISSION AVE, LIBERTY LAKE, WA 99019-9586
(509) 926-2600
(509) 891-2737
Mailing address
25415 E MISSION AVE, LIBERTY LAKE, WA 99019-9586
(509) 926-2600
(509) 891-2737

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
WAMD00025451
WA

Other

Enumeration date
03/10/2011
Last updated
03/10/2011
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