Mark W Clark is a Forensic in Portland, Oregon. Mark W Clark practices all healthcare services and medical treatments related to Forensic. The NPI Number for Mark W Clark is 1114081577. The last update date is 2007-07-09.
Mark W Clark's current location address is Po Box 82819, Portland, Oregon. You can contact this provider via phone number 5032335405 and fax number 5032332696. The mailing address for Mark W Clark is Po Box 82819, Portland, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark W Clark |
|---|---|
| Address | Po Box 82819, Portland, Oregon |
| Phone Number | 5032335405 |
| Fax Number | 5032332696 |
| Sole Proprietor | N |
| Credentials | PSY.D. |
NPI Number Detail
| NPI Number | 1114081577 |
|---|---|
| Provider Enumeration Date | 2006-12-20 |
| Last Updated Date | 2007-07-09 |
Provider Mailing Address Detail
| Address | Po Box 82819 |
|---|---|
| City | Portland |
| State | Oregon (OR) |
| Post Code | 972820819 |
| Phone Number | 5032335405 |
| Fax Number | 5032332696 |
Provider's Primary Taxonomy Detail
| Speciality | Forensic |
|---|---|
| Taxonomy | 103Tf0200X |
| Licence No | PY2226 |
|
Definition: A psychologist whose specialty is characterized by activities primarily intended to provide professional psychological expertise within the judicial and legal systems. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 164936 | OR | -- |
Post Comment/ Review Below
What is the Mark W Clark's 1114081577?
The Mark W Clark's NPI (National Provider Identifier) Number is 1114081577. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Mark W Clark's facilities are geographically located?
The facilities of Mark W Clark are physically situated at the following location: Po Box 82819, Portland, OR, 972820819.
What is Mark W Clark's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Mark W Clark is Forensic, and the taxonomy classification code that categorizes this area of expertise is 103Tf0200X.
On what date did the Centers for Medicare & Medicaid Services assign the 1114081577 to Mark W Clark?
The Centers for Medicare & Medicaid Services assigned the 1114081577 to Mark W Clark on 2006-12-20.
When was the Mark W Clark's information last updated?
The Mark W Clark's information was last updated on 2007-07-09.
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