Individual
TASHA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2114 W 6TH ST, PORT ANGELES, WA 98363-1614
(913) 530-1686
Mailing address
2114 W 6TH ST, PORT ANGELES, WA 98363-1614
(913) 530-1686
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN60515450
WA
Other
Enumeration date
05/04/2015
Last updated
05/04/2015
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