Individual
DEJANE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAPC, LMHCA, SUDPT
Contact information
Practice address
700 S 320TH ST STE A, FEDERAL WAY, WA 98003-4691
(206) 550-3455
Mailing address
700 S 320TH ST STE A, FEDERAL WAY, WA 98003-4691
(206) 550-3455
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CO61654772
WA
101YM0800X
Mental Health Counselor
APC009814
GA
101YM0800X
Mental Health Counselor
Primary
MC61654754
WA
Other
Enumeration date
08/01/2024
Last updated
02/05/2026
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