Individual
MR. CAMM D. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
149 W. 12TH AVENUE, EUGENE, OR 97401-6215
(541) 762-4400
(541) 344-0772
Mailing address
687 CHESHIRE AVENUE, EUGENE, OR 97402-5060
(541) 762-4400
(541) 344-0772
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
A3225
OR
1041C0700X
Clinical Social Worker
Primary
L6545
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L6545
LCSW
OR
Enumeration date
04/16/2013
Last updated
11/18/2015
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