Individual
CAROLYN CHEN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
640 ULUKAHIKI ST, KAILUA, HI 96734-4454
(503) 251-6855
Mailing address
PO BOX 16961, PORTLAND, OR 97292-0961
(503) 251-6855
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
21521
HI
Other
Enumeration date
04/20/2015
Last updated
04/12/2022
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