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Individual

SAMANTHA LEIGH CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
C-PNP

Contact information

Practice address
4904 RIVER RD N, KEIZER, OR 97303-4540
(503) 390-2434
Mailing address
4904 RIVER RD N, KEIZER, OR 97303-4540
(503) 390-2434

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
10047719
OR

Other

Enumeration date
11/08/2022
Last updated
07/22/2025
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