Individual
JENNIFER R CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1220 SW MORRISON ST STE 929, PORTLAND, OR 97205-2228
(503) 994-8811
Mailing address
PO BOX 8865, PORTLAND, OR 97207-8865
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2632
OR
Other
Enumeration date
11/12/2021
Last updated
11/12/2021
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