Clark, Alan W

Clark, Alan W is an individual health care provider with primary practice located at 1401 S Laventure Rd , Mount Vernon WA 98274-6033. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Clark, Alan W can be contacted via phone (360) 424-2400.

Contact Information

Primary practice address
1401 S Laventure Rd Mount Vernon WA 98274-6033
Phone: (360) 424-2400
Fax: (360) 424-2418
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA10004220 Washington
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA10004220 Washington

Profile Details

NPI number 1538196134
LBN Legal business name Clark, Alan W
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2006
Last updated Aug 14th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538196134 NPPES
Washington Other 0164819 L&I
Washington Other 263660 L&I
Washington MEDICAID 8406258 L&I

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