Individual
THEODORE JEFFREY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
17422 108TH AVE SE, #101, RENTON, WA 98055-5400
(425) 255-0427
(425) 255-1066
Mailing address
17422 108TH AVE SE, 101, RENTON, WA 98055-5400
(425) 255-0427
(425) 255-1066
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2219
WA
Other
Enumeration date
07/17/2010
Last updated
07/17/2010
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