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Contact Information

MACEY CLARK, PNP-C, AGNP-C
710 SUNSET DR
SUITE E
LA GRANDE, OR97850-1200
 Phone: 541-962-5600
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Gerontology

363LG0600X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for MACEY CLARK · (Female)

NPI # 1417483553
Status Active
Credentials PNP-C, AGNP-C
Entity Individual
Enumeration date 05/10/2017
Last updated 05/29/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • OR License # 201704371NP-PP
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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