Clark, Derek William

Clark, Derek William is an individual health care provider with primary practice located at 9135 Sw Barnes Rd Ste 461 , Portland OR 97225-6643. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Neurocritical Care. Allopathic & Osteopathic Physicians / Neurocritical Care is his primary health care specialty. Clark, Derek William can be contacted via phone (503) 216-1150.

Contact Information

Primary practice address
9135 Sw Barnes Rd Ste 461 Portland OR 97225-6643
Phone: (503) 216-1150
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X MD60658145 Washington
Allopathic & Osteopathic Physicians / Neurology 2084N0400X MD158550 Oregon
Allopathic & Osteopathic Physicians / Neurocritical Care 2084A2900X MD158550 Oregon

Profile Details

NPI number 1518283589
LBN Legal business name Clark, Derek William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 15th, 2010
Last updated Nov 25th, 2022 - about 4 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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