Individual
JEFFREY PAUL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
9633 MARKET PLACE, SUITE #103, LAKE STEVENS, WA 98258
(425) 335-0300
(425) 335-0302
Mailing address
9633 MARKET PLACE, SUITE #103, LAKE STEVENS, WA 98258
(425) 335-0300
(425) 335-0302
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH00002638
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350052980
RAILROAD MEDICARE
WA
01
—
43630
WORKERS COMP
WA
Enumeration date
02/22/2006
Last updated
03/06/2017
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