Individual
SEAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
6800 SW 105TH AVE STE 101, BEAVERTON, OR 97008-5488
(971) 200-1966
(971) 754-4141
Mailing address
6800 SW 105TH AVE STE 101, BEAVERTON, OR 97008-5488
(971) 200-1966
(971) 754-4141
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C6270
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500739602
—
OR
Enumeration date
10/10/2014
Last updated
04/18/2024
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