Individual
DR. CLARK M WAFFLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
407 14TH AVE SE, PUYALLUP, WA 98372-3770
(253) 848-6661
(253) 770-5990
Mailing address
6814 90TH ST E, PUYALLUP, WA 98371-6434
(253) 841-0174
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00021479
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002369
—
WA
Enumeration date
06/18/2006
Last updated
03/07/2008
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