Individual
CLINTON JAMES FORISKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
521 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4238
(253) 792-6680
(253) 403-2915
Mailing address
101 RAINBOW WAY UNIT B, KELSO, WA 98626-2046
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OP61573453
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
WA
Other
Enumeration date
07/20/2021
Last updated
05/15/2025
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