Individual
CHRISTINA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1400 E KINCAID ST, MOUNT VERNON, WA 98274-4127
(360) 428-2586
(360) 428-6470
Mailing address
1400 E KINCAID ST, MOUNT VERNON, WA 98274-4127
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA61126680
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/10/2020
Last updated
09/18/2023
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