Individual
CRYSTAL L CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RC
Contact information
Practice address
260 E 11TH AVE, EUGENE, OR 97401-3247
(541) 484-4428
(541) 484-7212
Mailing address
1790 W 11TH AVE STE 200, EUGENE, OR 97402-3871
(541) 686-2688
(541) 345-7605
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
RC60018186
WA
Other
Enumeration date
10/30/2008
Last updated
03/17/2018
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