Mary Clark
Registered Nurse in White City, OR. Individual provider (NPI-1).
NPI number1285043372
StatusActive
Last updated in NPPESAug 4, 2014
Details
- NPI
- 1285043372
- Entity type
- Individual (NPI-1)
- Name
- Mary Clark
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 4, 2014
- Last updated
- Aug 4, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | 200540995RN | OR | Yes |
| 163WC0400X | Registered Nurse, Case Management | 200540995RN | OR |
Practice location
8495 Crater Lake HwyWhite City, OR 97503-3011
Phone 541-826-2111 · Fax 541-830-7481
Mailing address
8495 Crater Lake HwyWhite City, OR 97503-3011
Phone 541-826-2111 · Fax 541-830-7481
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All 21 Registered Nurse providers in White City · All 349 providers in White City
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