Doctor Name: | ROBERT LEE CLARK |
NPI Number: | 1093009458 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MS |
License Number: | LH00007258 |
Business Practice Address: | 905 Ne 68th St Ste 2 Vancouver, WA - 986650585 |
Business Phone Number: | 3609918759 |
Business Fax Number: | 3605742806 |
Mailing Address: | 905 Ne 68th St, Ste 2 VANCOUVER |
State: | WA |
Postal Code: | 986650585 |
Phone Number: | 3609918759 |
Fax Number: | 3605742806 |
NPI Enumeration Date: | 06/02/2011 |
NPI Last Update Date: | 02/28/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | LH00007258 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |