Clark, Mary

Clark, Mary is an individual health care provider with primary practice located at 8495 Crater Lake Hwy , White City OR 97503-3011. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Nursing Service Providers / Case Management. Nursing Service Providers / Registered Nurse is her primary health care specialty. Clark, Mary can be contacted via phone (541) 826-2111.

Contact Information

Primary practice address
8495 Crater Lake Hwy White City OR 97503-3011
Phone: (541) 826-2111
Fax: (541) 830-7481
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 200540995RN Oregon
Nursing Service Providers / Case Management 163WC0400X 200540995RN Oregon

Profile Details

NPI number 1285043372
LBN Legal business name Clark, Mary
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 4th, 2014
Last updated Aug 4th, 2014 - about 10 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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