Individual provider · Type 1 NPI

Grace Clark

Student in an Organized Health Care Education/Training Program · Portland, OR

NPI number 1831879220 Active

Practice location

3716 NE Mlk Jr Blvd
Portland, OR 97212-1111

Call (503) 288-8066 Map

Mailing address

5302 E Main St Apt 253
Hillsboro, OR 97123-6418

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1831879220

Grace Clark's National Provider Identifier is 1831879220, issued on Jul 20, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Portland, OR. The record was last updated on Jul 20, 2023.