Clark, Dale Eugene
Clark, Dale Eugene is an individual health care provider with primary practice located at 109 Rainier Ave So Ste C , Eatonville WA 98328-0546. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Clark, Dale Eugene can be contacted via phone (360) 832-6200.Contact Information
Primary practice address
109 Rainier Ave So Ste C
Eatonville WA 98328-0546
Phone: (360) 832-6200
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | CH00001250 | Washington |
Profile Details
| NPI number | 1386787398 |
|---|---|
| LBN Legal business name | Clark, Dale Eugene |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 15th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386787398 | NPPES |
| Washington | Other | 2103109 | DSHS |
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