Individual
GRAHAM SCOTT CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2525 NE 139TH ST, STE 240, VANCOUVER, WA 98686-2719
(360) 882-2778
(360) 604-1726
Mailing address
700 NE 87TH AVE, STE 370, VANCOUVER, WA 98664-1913
(360) 397-3352
(360) 604-1771
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD60250520
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002796100
—
FL
Enumeration date
08/16/2007
Last updated
11/05/2012
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