IndividualActive
Holly Clark, PA-C
NPI 1447409446 · Physician Assistant · Granger, WA
Provider details
- NPI number
- 1447409446
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- PA60726169 (WA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
115 Sunnyside Ave
Granger, WA 98932
Phone: (509) 865-6450
Fax: (509) 854-1919
Approximate (ZIP-level) locationGet directions
Mailing address
115 Sunnyside Ave
Granger, WA 98932
Registry dates
- Enumerated
- 2008-09-15
- Last updated
- 2017-03-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.