Clarke, Ronald Larson

Clarke, Ronald Larson is an individual health care provider with primary practice located at 14279 Glen Oak Rd , Oregon City OR 97045-8008. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Clarke, Ronald Larson can be contacted via phone (503) 657-7629.

Contact Information

Primary practice address
14279 Glen Oak Rd Oregon City OR 97045-8008
Phone: (503) 657-7629
Fax: (503) 557-8651
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD16593 Oregon

Profile Details

NPI number 1699712000
LBN Legal business name Clarke, Ronald Larson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2006
Last updated Dec 11th, 2012 - about 12 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 1699712000 NPPES
Oregon MEDICAID 009496
Oregon Other 67972000

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