Individual
NINA MICHELLE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(517) 404-9671
Mailing address
1959 NE PACIFIC ST BOX 356410, SEATTLE, WA 98195-6410
(517) 404-9671
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/27/2019
Last updated
03/27/2019
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