Individual
MR. BRIAN KEITH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3322 BROADWAY, EVERETT, WA 98201-4425
(425) 349-7447
(425) 349-7339
Mailing address
3322 BROADWAY, EVERETT, WA 98201-4425
(425) 349-7447
(425) 349-7339
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW00006415
WA
Other
Enumeration date
06/26/2006
Last updated
07/08/2007
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