Individual
SAMANTHA JEAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
165 E HAWTHORNE AVE, COLVILLE, WA 99114-2629
(509) 684-4597
(509) 684-5286
Mailing address
165 E HAWTHORNE AVE, COLVILLE, WA 99114-2629
(509) 684-4597
(509) 684-5286
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN60583779
WA
Other
Enumeration date
12/31/2015
Last updated
12/31/2015
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