Jim Clark

NPI #1134694953 in Lacey, Washington

Provider Information

NPI Number: 1134694953
Entity Type: Individual
Name: Jim Clark
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor
Enumeration Date: Oct 8, 2018
Last Updated: Dec 19, 2018

Practice Location

Address: 612 WOODLAND SQUARE LOOP SE STE 401
City: Lacey
State: Washington
ZIP Code: 98503-1070
Phone: (360) 763-5828

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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