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Individual

RICHARD D CLARKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
400 S 3RD ST, RENTON, WA 98055-2026
(425) 353-3788
(425) 353-8041
Mailing address
PO BOX 84571, SEATTLE, WA 98124-5871
(425) 353-3788
(425) 353-8041

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30004891
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0153530
LABOR AND INDUSTRIES
WA
05
9631946
WA
Enumeration date
08/31/2006
Last updated
02/20/2012
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