Clark, Janice Patrece
Clark, Janice Patrece is an sole proprietor health care provider with primary practice located at 1660 S Columbian Way , Seattle WA 98108-1532. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Foot and Ankle Surgery, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is her primary health care specialty. Clark, Janice Patrece can be contacted via phone (206) 716-5651.Contact Information
Primary practice address
1660 S Columbian Way
Seattle WA 98108-1532
Phone: (206) 716-5651
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Foot and Ankle Surgery | 207XX0004X | POD001114 | Georgia |
| Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | CL011 | New Mexico |
| Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | 0689 | Arizona |
| Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | R57676 | New York |
| Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | POD001114 | Georgia |
Profile Details
| NPI number | 1811168339 |
|---|---|
| LBN Legal business name | Clark, Janice Patrece |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 13th, 2008 |
| Last updated | Jul 21st, 2022 - about 3 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 | 1811168339 | NPPES |
| Georgia | Other | 519981 | WELLCARE |
| Georgia | Other | 52246038-001 | WELLCARE |
| Georgia | Other | PAR | WELLCARE |
| Georgia | Other | PAR-2009-07-20 | WELLCARE |
| Georgia | MEDICAID | GPD114 | WELLCARE |
| Georgia | Other | 2009-07-20 | WELLCARE |
| Georgia | MEDICAID | 294861171A | WELLCARE |
| Georgia | Other | 1289105 | WELLCARE |
| Georgia | Other | 2009-10-01 | WELLCARE |
| Georgia | Other | 20091544 | WELLCARE |
| Georgia | Other | PAR-2009-08-28 | WELLCARE |
| Georgia | Other | 2009-08-01 | WELLCARE |
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