Individual
TERRENCE T. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5821 SPRAGUE CT., TACOMA, WA 98409
(253) 396-4200
Mailing address
PO BOX 34584, SEATTLE, WA 98124-1584
(509) 241-7349
(509) 241-7628
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00001204
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2073807
—
WA
Enumeration date
01/03/2007
Last updated
05/09/2008
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