Clark, Elaine M

Clark, Elaine M is an sole proprietor health care provider with primary practice located at 710 Nw Juniper St , Issaquah WA 98027-2717. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Clark, Elaine M can be contacted via phone (425) 392-7989.

Contact Information

Primary practice address
710 Nw Juniper St Issaquah WA 98027-2717
Phone: (425) 392-7989
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 2251P0200X PT00000762 Washington

Profile Details

NPI number 1295825511
LBN Legal business name Clark, Elaine M
Credentials Master of Physical Therapy (MPT)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 15th, 2006
Last updated Jul 8th, 2007 - about 18 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 1295825511 NPPES
Washington MEDICAID 7038649

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