Individual
DIEDRA FRIE CLARK-RIXMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
7300 E GREEN LAKE DR N, SEATTLE, WA 98115-8604
(206) 354-4301
Mailing address
332 25TH AVE, SEATTLE, WA 98122-6106
(206) 354-4301
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00013490
WA
Other
Enumeration date
05/07/2007
Last updated
07/08/2007
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