Individual
MS. DIANA MARTHA CLARK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LCSW MSW MA DMIN
Contact information
Practice address
15100 SW BOONES FERRY RD, STE 850, LAKE OSWEGO, OR 97035-3423
(503) 636-1625
(503) 635-9127
Mailing address
15100 SW BOONES FERRY RD, STE 850, LAKE OSWEGO, OR 97035-3423
(503) 636-1625
(503) 635-9127
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1594
OR
Other
Enumeration date
02/01/2006
Last updated
07/08/2007
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