Clark, Kelly Marie

Clark, Kelly Marie is an individual health care provider with primary practice located at 811 Madison St , Everett WA 98203-4543. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Peer Specialist, Behavioral Health & Social Service Providers / Mental Health. Other Service Providers / Peer Specialist is her primary health care specialty. Clark, Kelly Marie can be contacted via phone (425) 212-4200.

Contact Information

Primary practice address
811 Madison St Everett WA 98203-4543
Phone: (425) 212-4200
Fax: (425) 212-4201
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X 1477897916 Washington
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1477897916
LBN Legal business name Clark, Kelly Marie
Credentials AAC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 22nd, 2012
Last updated Mar 17th, 2018 - about 6 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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