Individual
JOAN GATHJE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
UNIVERSITY OF WASHINGTON MEDICAL CTR, 1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(206) 288-1000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
MD00022064
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0230887
L&I
WV
05
—
1386720126
—
WI
01
—
3003
INTERNAL ID-MOTOR VEHICLE ID
—
Enumeration date
10/27/2006
Last updated
01/21/2012
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