Individual
ALEXANDER VICTOR CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3455 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-3076
(601) 209-3402
Mailing address
476 SW 150TH AVE, BEAVERTON, OR 97006-5759
(601) 209-3402
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
10041823
OR
Other
Enumeration date
07/08/2025
Last updated
07/08/2025
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