Individual
MRS. DENISE MICHELLE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR CHT
Contact information
Practice address
12911 120TH AVE NE, SUITE H 220, KIRKLAND, WA 98034-3027
(425) 216-7075
(425) 216-7094
Mailing address
805 MADISON ST, SUITE 901, SEATTLE, WA 98104-1172
(206) 264-8100
(206) 264-8689
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT00001716
WA
225XH1200X
Hand Occupational Therapist
Primary
9711000164
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
126095
L & I
WA
01
—
7466CL
REGENCE
WA
05
—
7680697
—
WA
Enumeration date
03/07/2007
Last updated
10/18/2011
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