Individual
LAURA ELIZABETH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
305 PACIFIC AVE S STE C, KELSO, WA 98626-1638
(360) 644-1047
Mailing address
18458 POTTER RD, CLATSKANIE, OR 97016-2119
(503) 396-3737
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP61013657
WA
Other
Enumeration date
12/11/2023
Last updated
12/11/2023
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