Organization
S L CLARK MD INC PS
Active
Other names
Susan L. Clark, M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN L CLARK MD (PRESIDENT)
(425) 355-2800
Entity
Organization
Contact information
Practice address
9515 60TH AVE W, MUKILTEO, WA 98275
(425) 355-2800
(425) 355-2882
Mailing address
9515 60TH AVE W, MUKILTEO, WA 98275
(425) 355-2800
(425) 355-2882
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
MD00022790
WA
103TP0814X
Psychoanalysis Psychologist
Primary
MD00022790
WA
Other
Enumeration date
10/16/2007
Last updated
04/19/2011
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