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NPI Code Detail

MEDICARE: CHIENHUA H CLARKE MD

MEDICARE: CHIENHUA H CLARKE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician4301082531MI

General Provider Information

NPI Number : 1538291687
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHIENHUA H CLARKE MD
Provider Business Mailing Address
First Line : 9040 JACKSON AVE
Second Line :
City : TACOMA
State : WA
Zip : 98431-2421
Country : US
Telephone Number : 248-799-0093
Fax Number :
Provider Business Practice Location Address
First Line : 9040 JACKSON AVE
Second Line :
City : TACOMA
State : WA
Zip : 98431-2421
Country : US
Telephone Number : 248-799-0093
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2007
Last Update Date : 03/20/2020

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