NPI 1770871113

Benjamin Clark, CPO

Practitioner Prosthetist Portland, OR

Practice location

Address: 17316 NE Halsey St, Portland, OR 97230-6026
Phone: (503) 257-6623

Registered specialties (2)

Prosthetist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X

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Orthotist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 222Z00000X

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Registry record

NPI: 1770871113
Entity type: Individual
Sex (as registered): Male
NPI issued: 19 Jul 2011
Record last updated: 1 Mar 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.