Provider Demographics
NPI:1225547151
Name:CLARK, DIONNE MARIE (CPC, AAC)
Entity Type:Individual
Prefix:
First Name:DIONNE
Middle Name:MARIE
Last Name:CLARK
Suffix:
Gender:F
Credentials:CPC, AAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9105 NE HIGHWAY 99 STE 201A
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-8974
Mailing Address - Country:US
Mailing Address - Phone:360-932-5390
Mailing Address - Fax:360-597-9722
Practice Address - Street 1:9105 NE HIGHWAY 99 STE 201A
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8974
Practice Address - Country:US
Practice Address - Phone:360-932-5390
Practice Address - Fax:360-597-9722
Is Sole Proprietor?:No
Enumeration Date:2017-09-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist