Clark, Nicholas
Clark, Nicholas is an individual health care provider with primary practice located at 4011 Talbot Rd S Ste 300 , Renton WA 98055-5791. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Clark, Nicholas can be contacted via phone (425) 656-5060.Contact Information
Primary practice address
4011 Talbot Rd S Ste 300
Renton WA 98055-5791
Phone: (425) 656-5060
Fax: (425) 656-5047
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 60704 | Minnesota |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine | 207XS0117X | MD61156092 | Washington |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | MD61156092 | Washington |
Profile Details
| NPI number | 1407235724 |
|---|---|
| LBN Legal business name | Clark, Nicholas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 19th, 2015 |
| Last updated | Aug 19th, 2021 - 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 | 1407235724 | NPPES |
| Washington | Other | 440706 | WA LABOR & INDUSTRIES |
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