Individual
DR. TIA MICHELLE CLOKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, ARNP, NP-C
Contact information
Practice address
2073 OLYMPIC ST, SPRINGFIELD, OR 97477-3413
(541) 682-3550
(541) 682-3551
Mailing address
2073 OLYMPIC ST, SPRINGFIELD, OR 97477-3413
(541) 682-3550
(541) 682-3551
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201709218NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500736139
—
OR
Enumeration date
06/25/2013
Last updated
05/01/2024
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