Individual provider · Type 1 NPI
Mariko Fukuyama Clark, LMHC
Mental Health Counselor · Portland, OR
NPI number
1467819904
Active
Practice location
3706 SW Beaverton Ave
Portland, OR 97239-1506
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | LH60601506 (WA) |
Mental Health Counselor: Definition to come...
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About NPI 1467819904
Mariko Fukuyama Clark, LMHC's National Provider Identifier is 1467819904, issued on Jan 27, 2016. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, OR. The record was last updated on Jan 27, 2016.