Clark, Sean

Clark, Sean is an individual health care provider with primary practice located at 6800 Sw 105Th Ave Ste 101 , Beaverton OR 97008-5488. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Clark, Sean can be contacted via phone (971) 200-1966.

Contact Information

Primary practice address
6800 Sw 105Th Ave Ste 101 Beaverton OR 97008-5488
Phone: (971) 200-1966
Fax: (971) 754-4141
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X C6270

Profile Details

NPI number 1689078271
LBN Legal business name Clark, Sean
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2014
Last updated Apr 18th, 2024 - about 2 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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Identifiers

StateTypeNumberIssuer
All States NPI 1689078271 NPPES
Oregon MEDICAID 500739602

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