Individual provider · Type 1 NPI

Carly A. Clark, PSS

Peer Specialist · Gresham, OR

NPI number 1689375529 Active

Practice location

620 NE 2nd St
Gresham, OR 97030-7514

Call (971) 274-3757 Map

Mailing address

1776 SW Madison St
Portland, OR 97205-1715

Specialties and licenses

TaxonomyCodeLicense
Behavior Technician 106S00000XNone listed
Peer Specialist Primary 175T00000XTHW000107924 (OR)

Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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About NPI 1689375529

Carly A. Clark, PSS's National Provider Identifier is 1689375529, issued on Mar 16, 2023. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Gresham, OR. The record was last updated on Mar 16, 2023.