Individual
LARA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1112 S CUSHMAN AVE, TACOMA, WA 98405-3631
(253) 593-2144
(253) 272-4125
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
(206) 764-3335
(206) 764-0489
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP60376142
WA
Other
Enumeration date
08/21/2013
Last updated
08/21/2013
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