| Dr Patricia Clark | |
|
1132 Sw 19th Ave Portland OR 97205-1740 | |
| (503) 241-5452 | |
| Not Available |
| Full Name | Dr Patricia Clark |
|---|---|
| Speciality | Psychologist |
| Location | 1132 Sw 19th Ave, Portland, Oregon |
| Authorized Official Name and Position | Patricia Clark (OWNER) |
| Authorized Official Contact | 5032940940 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Patricia Clark 1132 Sw 19th Ave Portland OR 97205-1740 Ph: (503) 241-5452 | Dr Patricia Clark 1132 Sw 19th Ave Portland OR 97205-1740 Ph: (503) 241-5452 |
| NPI Number | 1093241838 |
|---|---|
| Provider Enumeration Date | 05/11/2017 |
| Last Update Date | 05/11/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093241838 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 1456 (Oregon) | Primary |
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