Individual
JAMES E CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3021 GRIFFIN AVE, ENUMCLAW, WA 98022-2369
(360) 825-6511
(360) 825-6536
Mailing address
3021 GRIFFIN AVE, ENUMCLAW, WA 98022-2369
(360) 825-6511
(360) 825-6536
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00013526
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1062207
—
WA
01
—
126689
STATE L&I
WA
01
—
8928598
STATE CRIME VICTIMS
WA
Enumeration date
08/09/2006
Last updated
02/22/2008
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