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Contact Information

S L CLARK MD INC PS
9515 60TH AVE W
MUKILTEO, WA98275
 Phone: 425-355-2800
 Fax: 425-355-2882
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychoanalysis

103TP0814X 62 Psychologist, Clinical
 

Prescribing (Medical)

103TP0016X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for S L CLARK MD INC PS

NPI Number 1528257433
LBN Legal business name S L CLARK MD INC PS
Authorized official SUSAN CLARK - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 10/16/2007
Last updated 04/19/2011 - About 15 years ago
Identifiers
WA License # MD00022790
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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