Kerry R Clark, RD
Dietitian, Registered in Spokane, WA. Individual provider (NPI-1).
NPI number1114366168
StatusActive
Last updated in NPPESMay 3, 2021
Details
- NPI
- 1114366168
- Entity type
- Individual (NPI-1)
- Name
- Kerry R Clark
- Credential
- RD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 21, 2013
- Certification date
- May 3, 2021
- Last updated
- May 3, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | DI00000348 | WA | Yes |
Other names
- Kerry Scott (Former Name)
Practice location
101 W 8th AveSuite 1100
Spokane, WA 99204-2307
Phone 509-474-4060
Mailing address
Po Box 421Liberty Lake, WA 99019-0421
Phone 866-747-2455
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