Individual
CLARK WHEELER DEEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
316 MARTIN LUTHER KING JR WAY STE 402, TACOMA, WA 98405-4261
(253) 792-6630
(253) 403-7205
Mailing address
PO BOX 5299, MS: 820-5-PCO, TACOMA, WA 98415-0299
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD00012765
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1060896
—
WA
01
—
180046385
RAILROAD MEDICARE
—
01
—
DE7443
BLUE SHIELD
—
Enumeration date
06/16/2006
Last updated
02/26/2024
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