Individual
MRS. GEORGIANNE M CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
306 5TH ST, CLARKSTON, WA 99403-1860
(509) 758-9470
(509) 758-9478
Mailing address
1239 VINEYARD AVE, LEWISTON, ID 83501-4271
(509) 758-9470
(509) 758-9478
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
OPTI.DO.61617192
WA
Other
Enumeration date
10/22/2025
Last updated
10/22/2025
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