Individual
LORETTA A CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
216 W PACIFIC AVE, SUITE 205, SPOKANE, WA 99201-3661
(509) 413-7070
Mailing address
539 E HEROY AVE, SPOKANE, WA 99207-1535
(509) 413-7070
(509) 489-4674
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
MA60097219
WA
Other
Enumeration date
04/05/2011
Last updated
11/10/2014
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