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General NPI Number Information
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NPI Number | 1780570218
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Entity Type | Individual
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Provider Name | WENDY CLARKE
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Gender | Female
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Dates
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Enumeration Date | 06/12/2025
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Last Update Date | 06/15/2025
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Provider Practice Location Address
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Address Line | 3713 PACIFIC AVE STE E
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City | TACOMA
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State | WA
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Zip | 98418-7845
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Country | US
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Telephone | 253-433-7993
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Fax | 253-540-6886
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Provider Business Mailing Address
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Address Line | 3713 PACIFIC AVE STE E
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City | TACOMA
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State | WA
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Zip | 98418-7845
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Country | US
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Telephone | 509-216-5469
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | RN60465538
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License Number State | WA
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