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Contact Information

SAMANTHA L CLARK, C-PNP
4904 RIVER RD N
KEIZER, OR97303-4540
 Phone: 503-390-2434
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

363LP0200X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for SAMANTHA L CLARK · (Female)

NPI # 1841908894
Status Active
Credentials C-PNP
Entity Individual
Enumeration date 11/08/2022
Last updated 07/22/2025 - About 11 months ago
Sole proprietor 1 No
Identifiers
  • OR License # 10047719
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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