Individual
CHRISTOPHER J CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3003 TIETON DR, SUITE 320, YAKIMA, WA 98902-3679
(509) 452-3765
Mailing address
3003 TIETON DR, SUITE 320, YAKIMA, WA 98902-3679
(509) 452-3765
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OP00000895
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00850913
RAILROAD MEDICARE
WA
Enumeration date
07/26/2006
Last updated
11/22/2010
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