Individual
MRS. TERESA JILL CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
404 W 15TH AVE, SPOKANE, WA 99203-2110
(509) 209-9664
(509) 747-0609
Mailing address
404 W 15TH AVE, SPOKANE, WA 99203-2110
(509) 209-9664
(509) 919-4532
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/13/2012
Last updated
04/25/2026
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