Individual
MS. CAMILLE S. CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
2408 10TH AVE E APT A, SEATTLE, WA 98102-4050
(206) 380-9848
(206) 325-9848
Mailing address
2408 10TH AVE E APT A, SEATTLE, WA 98102-4050
(206) 380-9848
(206) 325-9848
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00005148
WA
Other
Enumeration date
03/01/2007
Last updated
07/08/2007
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