Doctor Name: | LYNN A CLARK |
NPI Number: | 1023024940 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | AP30002563 |
Business Practice Address: | 11511 Canterwood Blvd Nw Ste 145 Gig Harbor, WA - 983325813 |
Business Phone Number: | 2535302955 |
Business Fax Number: | 2535302970 |
Mailing Address: | 11511 Canterwood Blvd Nw, Ste 145 GIG HARBOR |
State: | WA |
Postal Code: | 983325813 |
Phone Number: | 2535302955 |
Fax Number: | 2535302970 |
NPI Enumeration Date: | 07/31/2006 |
NPI Last Update Date: | 11/18/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LX0001X |
License Number: | AP30002563 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Obstetrics & Gynecology |
Taxonomy Definition: |