Katie Jane Clark
Specialist in Lebanon, OR. Individual provider (NPI-1).
NPI number1780225474
StatusActive
Last updated in NPPESOct 3, 2019
Details
- NPI
- 1780225474
- Entity type
- Individual (NPI-1)
- Name
- Katie Jane Clark
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 3, 2019
- Last updated
- Oct 3, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | – | Yes |
Practice location
44 Industrial Way Ste DLebanon, OR 97355-4364
Phone 541-801-4113
Mailing address
1305 Hill St SeAlbany, OR 97322-6711
Phone 541-801-4113
Other practice locations
44 Industrial Way Ste D
Lebanon, OR 97355-4364
Lebanon, OR 97355-4364
Phone 541-259-5880
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Other Specialist providers in Lebanon, OR
- Patrick R Burkett, M.D.NPI 1932377561
- Debra Lynn Joseph, P.T.NPI 1235306945
- Kathy King Newman, PTNPI 1215236120
- Carli Wymore, CPTNPI 1750832887
All 5 Specialist providers in Lebanon · All 723 providers in Lebanon
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