Individual
NANCY L CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
13033 BELLEVUE REDMOND RD, #110, BELLEVUE, WA 98005-2633
(425) 468-6500
(425) 468-6501
Mailing address
13033 BELLEVUE REDMOND RD, #110, BELLEVUE, WA 98005-2633
(425) 468-6500
(425) 468-6501
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10003692
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
171527
LABOR AND INDUSTRIES
WA
Enumeration date
02/09/2007
Last updated
09/15/2008
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