Provider Demographics
NPI:1942284476
Name:CLARKE, CHRISTINE S (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:S
Last Name:CLARKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:875 OAK ST SE
Mailing Address - Street 2:SUITE 4010
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3975
Mailing Address - Country:US
Mailing Address - Phone:503-364-6843
Mailing Address - Fax:503-585-5273
Practice Address - Street 1:875 OAK ST SE
Practice Address - Street 2:SUITE 4010
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3975
Practice Address - Country:US
Practice Address - Phone:503-364-6843
Practice Address - Fax:503-585-5273
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2018-12-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORMD27024208600000X
LA022836208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery