Individual
ASHLEY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
825 EASTLAKE AVE E, SEATTLE, WA 98109-4405
(206) 288-1000
Mailing address
975 JOHN ST APT 421, SEATTLE, WA 98109-5273
(607) 437-6542
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60672205
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417306077
—
WA
Enumeration date
06/05/2016
Last updated
03/17/2018
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