Individual
CAROLE A CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
4420 76TH ST NE, MARYSVILLE, WA 98270-3726
(360) 339-5492
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(425) 258-3900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP30003020
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP30003020
LICENSE
WA
Enumeration date
11/06/2006
Last updated
12/31/2019
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