Individual
MICHAEL E CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98431-1100
(253) 968-1159
Mailing address
12725 172ND ST E, APT GG-204, PUYALLUP, WA 98374-8709
(251) 605-9018
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
28952
AL
207V00000X
Obstetrics & Gynecology Physician
Primary
MD60844955
WA
Other
Enumeration date
09/28/2006
Last updated
02/02/2021
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