JEFFREY PAUL CLARK (NPI# 1366417487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366417487 |
| Entity Type | Individual |
| Full Name | JEFFREY PAUL CLARK |
| Credential | D.C. |
| Practice Address |
9633 Market Place Suite #103 Lake Stevens WA 98258 |
| Practice Telephone | 4253350300 |
| Practice Fax Number | 4253350302 |
| Mailing Telephone | 4253350300 |
| Mailing Fax Number | 4253350302 |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2017-03-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CH00002638 | WA | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | RAILROAD MEDICARE | 350052980 | 01 |
| WA | WORKERS COMP | 43630 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619505914 | Jeffrey Scott Clark | Counselor | 402 E Yakima Ave Ste 800-c, Yakima, WA 98901-5407 | 2020-03-31 |
| 1063805844 | Jeffrey Clark | Specialist/Technologist | 315 Reber Ave, Lancaster, OH 43130-1761 | 2015-03-18 |
| 1134535248 | Jeffrey Clark | Hearing Instrument Specialist | 123 E Mondamin St, Minooka, IL 60447-9896 | 2014-07-09 |
| 1174942353 | Jeffrey Clark | Pediatrics | 9576 Hwy 70, Department of Pediatrics, Minocqua, WI 54548 | 2014-04-15 |
| 1881958767 | Jeffrey Kenneth Clark | Pharmacist | 12850 E Montview Blvd Ste C238, Aurora, CO 80045-2605 | 2012-06-26 |
| 1912285495 | Jeffrey S Clark | Chiropractor | 203 Railroad St Ste 3c, Buda, TX 78610-3437 | 2011-08-01 |
| 1003100934 | Jeffrey Paul Clark | Dentist | 1403 N Loop 336 W, Conroe, TX 77304-3503 | 2011-06-08 |
| 1942520044 | Jeffrey B Clark | Dentist | 2133 Belcourt Avenue, Nashville, TN 37212-3503 | 2010-06-11 |
| 1730405333 | Jeffrey Clark | Pharmacist | 611 N Perry St, Bldg #2, Suite 202, Spokane, WA 99202-5011 | 2010-04-08 |
| 1891989158 | Jeffrey Michael Clark | Dentist | 10429 Lagrima De Oro Rd Ne, Albuquerque, NM 87111 | 2007-08-30 |
| Street Address |
9633 MARKET PLACE SUITE #103 |
| City | LAKE STEVENS |
| State | WA |
| Zip Code | 98258 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790349116 | Page A Thompson | Assistant Behavior Analyst | 9821 North Davies Rd, Lake Stevens, WA 98258 | 2019-05-01 |
| 1811490550 | Washington Dental Corporation PC | Dentist | 907 Frontier Circle E, Suite 110, Lake Stevens, WA 98258 | 2018-03-08 |
| 1881140499 | Tracy L. Delorm, D.d.s. Pllc | Dentist | 9514 4th St. Ne Unit 102, Lake Stevens, WA 98258 | 2016-09-01 |
| 1932587870 | Nathan Cory | Contractor | 25 95th Dr Ne #105, Lake Stevens, WA 98258 | 2015-05-12 |
| 1902249063 | Troy Slover | Family Medicine | 31 Ne Route 300 Suite 200, Belfair, WA 98258 | 2013-04-09 |
| 1154675064 | Pspd - Lake Stevens Pllc | Dentist | 9421 N. Davies Road #a, Lake Stevens, WA 98258 | 2012-10-30 |
| 1053670364 | Ashley Nicole Sherman | Massage Therapist | 9623 32nd St Se Bldg D Ste 115, Lake Stevens, WA 98258 | 2012-05-07 |
| 1326344391 | Lyman Charles Drown | Specialist/Technologist | 9514 4th Street Ne, Suite 101, Lake Stevens, WA 98258 | 2011-02-08 |
| 1942504071 | Rebekah Erin Callahan | Marriage & Family Therapist | 7304 10th St. Se #b201, Lake Stevens, WA 98258 | 2011-01-04 |
| 1376857235 | Ronald L Rhea | Massage Therapist | 7812 12th St Se, Lake Stevens, WA 98258 | 2010-08-03 |
| Find all providers in zip 98258 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982124046 | Mill Creek Spine and Injury, Inc., P.s. | Chiropractor | 1112 76th Ave Ne, Lake Stevens, WA 98258-3201 | 2017-06-21 |
| 1760729040 | Michelle Christine Flynn | Chiropractor | 9633 Market Pl Unit 103, Lake Stevens, WA 98258-7944 | 2013-01-07 |
| 1053684241 | Vanessa R Wise | Chiropractor | 905 Sr 9, Lake Stevens, WA 98258-9484 | 2012-02-17 |
| 1417120957 | Johnstone Chiropractic Inc Ps | Chiropractor | 515 State Route 9 Ne, Suite 105, Lake Stevens, WA 98258-8523 | 2008-04-04 |
| 1497943153 | Jerry Stanley Johnstone II | Chiropractor | 515 Sr 9 Ne, Suite 105, Lake Stevens, WA 98258-8523 | 2007-10-09 |
| 1790803468 | Kurt A Edmark | Chiropractor | 10519 20th St Se, Ste #1, Lake Stevens, WA 98258-4769 | 2007-03-27 |
| 1467592741 | J. Marvin Gaddis | Chiropractor | 905 State Route 9 Ne, Lake Stevens, WA 98258-9484 | 2007-02-07 |
| 1235104712 | J Marvin Gaddis | Chiropractor | 905 Hwy 9, Lake Stevens, WA 98258-9484 | 2006-02-20 |
| 1629074497 | Nicole Allison Morin | Chiropractor | 9327 4th St Ne, Suite 6, Lake Stevens, WA 98258-1630 | 2005-06-24 |
| 1144699190 | Edmark Chiropractic Pllc | Chiropractor | 10519 20th St Se, Suite 1, Lake Stevens, WA 98258-4768 | 2015-09-21 |
| Find all providers in LAKE STEVENS | ||||
| City | LAKE STEVENS |
| Zip Code | 98258 |
Please comment or provide details below to improve the information on JEFFREY PAUL CLARK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.