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NPI Profile for JOHN P CLARK in ROYAL CITY, WA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Medical |
363AM0700X | 97 | Physician Assistant |
| NPI # | 1811922982 |
|
| Status | Active | |
| Credentials | PAC | |
| Entity | Individual | |
| Enumeration date | 07/11/2006 | |
| Last updated | 07/08/2007 - About 19 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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JOHN P CLARK
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JOHN P CLARK, PAC