Individual
DEREK WILLIAM CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9135 SW BARNES RD STE 461, PORTLAND, OR 97225-6643
(503) 216-1150
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
2084A2900X
Neurocritical Care Physician
Primary
MD158550
OR
2084N0400X
Neurology Physician
MD158550
OR
2084N0400X
Neurology Physician
MD60658145
WA
Other
Enumeration date
04/15/2010
Last updated
11/25/2022
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