Individual
DR. RICHARD TRAVIS CLARK
Active
Individual
DR. RICHARD TRAVIS CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD2018-0142
NM
2085R0202X
Diagnostic Radiology Physician
MD60212011
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0293210
L&I
WA
01
—
0365595
L&I RADIA-REST OF WA
WA
01
—
0365598
L&I RADIA-KING COUNTY
WA
01
—
0365599
L&I SWEDISH RADIA EDMONDS
WA
01
—
0365600
L&I EVERGREEN RADIA
WA
05
—
1568432557
—
WA
01
—
158600
PTAN
WA
05
—
2017034
—
WA
Enumeration date
01/24/2006
Last updated
01/30/2025
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