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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. JOHN P CLARK, PAC

Active

MR. JOHN P CLARK, PAC is a Medical Physician Assistant healthcare provider located in ROYAL CITY, Washington. NPI 1811922982 is currently active in the NPPES registry. Verify at CMS.

Medical Physician Assistant · ROYAL CITY, WA

Registration Details

NPI Number
1811922982
Provider Type
Individual
Gender
Male
NPI Issued
Jul 11, 2006 (20.069088420548 yrs)
Last Updated
Jul 8, 2007
Licenses
PA10001599 (WA)
PA11682 (CA)

Practice Information

Address
101 CAMELIA ST NW
ROYAL CITY, WA, 99357
Browse WA providers · Browse ZIP 99357
Phone
5093461447
Fax
5093461481
Primary Specialty
Medical Physician Assistant
363AM0700X
Additional Specialty
Medical Physician Assistant
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.