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Individual

MARK JUSTIN CLARY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMP

Contact information

Practice address
8294 28TH CT NE STE 100, LACEY, WA 98516-7140
(360) 951-9211
Mailing address
390 W INSELS RD, SHELTON, WA 98584-9167
(360) 951-9211

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60439284
WA

Other

Enumeration date
04/28/2016
Last updated
04/28/2016
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