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Contact Information

MICHELLE CLARK, DO
9040 JACKSON AVE
TACOMA, WA98431-5001
 Phone: 253-968-3885
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Developmental - Behavioral Pediatrics

2080P0006X 37 Physician/Pediatric Medicine
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for MICHELLE CLARK · (Female)

NPI # 1588804082
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 02/24/2009
Last updated 01/06/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • HI License # DOS-1211
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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