Individual provider · Type 1 NPI
John P. Clark, PAC
Medical Physician Assistant · Royal City, WA
NPI number
1811922982
Active
Practice location
101 Camelia St NW
Royal City, WA 99357
Fax (509) 346-1481
Mailing address
PO Box 1028, 101 Camelia St NW
Royal City, WA 99357
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | PA10001599 (WA) |
| Medical Physician Assistant | 363AM0700X | PA11682 (CA) |
Medical Physician Assistant: Definition to come...
Another provider at this address
About NPI 1811922982
John P. Clark, PAC's National Provider Identifier is 1811922982, issued on Jul 11, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Royal City, WA. The record was last updated on Jul 8, 2007.