DR. BRENT A CLARK (NPI# 1407820418) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407820418 |
| Entity Type | Individual |
| Full Name | DR. BRENT A CLARK |
| Credential | D.P.M. |
| Practice Address |
526 N Mullan Rd Spokane Valley WA 99206-2408 |
| Practice Telephone | 5099242600 |
| Practice Fax Number | 5099269865 |
| Mailing Telephone | 5099242600 |
| Mailing Fax Number | 5099269865 |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2017-03-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | PO00000693 | WA | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
PO00000693 | WA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 8275620 | 05 | |
| WA | RAIL ROAD MEDICARE | 4800319393 | 01 |
| OR | 230612 | 05 | |
| WA | L&I | 148232 | 01 |
| ID | 807068300 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508906751 | Brent Gilford Clark | Dentist | Us 23 Hayes Complex, Betsy Layne, KY 41605-0001 | 2007-02-07 |
| 1174636419 | Brent Wayne Clark | Dentist | 103 Superior Dr, Spring Lake, NC 28390-3193 | 2006-08-17 |
| 1902874456 | Brent Clark | Family Medicine | 9816 Frankstown Rd, Pittsburgh, PA 15235-1643 | 2006-03-10 |
| 1952830226 | Brent Clark | Nurse Practitioner | 631 Main Street, Bethel, AK 99559-1908 | 2017-06-08 |
| Street Address |
526 N MULLAN RD |
| City | SPOKANE VALLEY |
| State | WA |
| Zip Code | 99206-2408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134127657 | Inland Northwest Surgery Center Pllc | Podiatrist | 526 N Mullan Rd, Suite A & B, Spokane Valley, WA 99206-2407 | 2005-07-08 |
| 1518142652 | Inland Northwest Surgery Center Pllc | Durable Medical Equipment & Medical Supplies | 526 N Mullan Rd, Ste B, Spokane Valley, WA 99206-2408 | 2008-01-08 |
| 1467637116 | Inland Northwest Surgery Center Pllc | Clinic/Center | 526 N Mullan Rd, Ste. A, Spokane Valley, WA 99206-2408 | 2007-12-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851913495 | Ea Healing Arts LLC | Acupuncturist | 210 N University Rd, Ste 200, Spokane Valley, WA 99206 | 2020-05-16 |
| 1922659630 | Creative Harmony Counseling LLC | Counselor | 721 N Pines Road, Spokane, WA 99206 | 2019-09-24 |
| 1477027092 | Hunter Badgley | Counselor | 721 N Pines Rd Ste 2, Spokane Valley, WA 99206 | 2019-01-16 |
| 1851880934 | Ryan Bushman | Dentist | 919 N Pines Rd, Spokane Valley, WA 99206 | 2018-05-04 |
| 1902307531 | Lois Jensen | Counselor | 3507 S. Spotted Rd., Spokane, WA 99206 | 2018-02-28 |
| 1295258804 | Melissa Ann Reamer | Speech-Language Pathologist | 2510 N. Pines Rd., Ste. 3, Spokane Valley, WA 99206 | 2017-07-25 |
| 1730619149 | Amanda Kathryn Fuchs | Counselor | 200 N Mullan Rd Ste 219, Spokane Valley, WA 99206 | 2017-06-18 |
| 1588105308 | Pine Ridge Management Wa LLC | Assisted Living Facility | 5615 West Umatilla, Spokane, WA 99206 | 2017-03-13 |
| 1427405893 | Sarah Winn | Counselor | 721 N Pines, Spokane Valley, WA 99206 | 2016-05-16 |
| 1134573199 | Elzbieta H Anderson | Acupuncturist | 210 N University Rd Ste 200, Spokane Valley, WA 99206 | 2016-04-15 |
| Find all providers in zip 99206 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053481200 | Kirk Maclennan Herring | Podiatrist | 1215 N Mcdonald Road, Suite 201, Spokane Valley, WA 99216 | 2006-11-08 |
| 1730297573 | Stewart Pugmire Brim | Podiatrist | 1120 N Pines Rd, Spokane Valley, WA 99206-4942 | 2006-08-29 |
| 1134127657 | Inland Northwest Surgery Center Pllc | Podiatrist | 526 N Mullan Rd, Suite A & B, Spokane Valley, WA 99206-2407 | 2005-07-08 |
| 1306963509 | Spokane Podiatry Ps | Podiatrist | 1120 N Pines Road, Spokane Valley, WA 99206 | 2007-03-23 |
| 1104943141 | Nathan C Dikes Dpm PC | Podiatrist | 10410 E 9th Ave, Spokane Valley, WA 99206-3510 | 2007-03-23 |
| 1093818890 | Nathan Craig Dikes | Podiatrist | 10410 E 9th Ave, Spokane Valley, WA 99206-3510 | 2006-09-07 |
| 1003809252 | Shani Mcginnis | Podiatrist | 14408 E Sprague Ave, Spokane Valley, WA 99216-2167 | 2005-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003449430 | Seniorwell Pod of Washington LLC | Podiatrist | 506 Secord Avenue, Suite 1400, Seattle, WA 98104-2329 | 2020-02-13 |
| 1790337194 | Nw Foot and Ankle Specialists, LLC | Podiatrist | 12900 Ne 180th St, Ste 150, Bothell, WA 98011 | 2019-07-15 |
| 1174091193 | Fasa Family Wellness Pllc | Podiatrist | 5210 Corporate Center Ct Se Ste A, Lacey, WA 98503-5952 | 2018-11-07 |
| 1407227424 | Jeremy Cross | Podiatrist | 9399 Ridgetop Blvd Nw Ste A, Silverdale, WA 98383-8505 | 2015-10-16 |
| 1326427584 | Mallory Schweitzer | Podiatrist | 11212 Sunrise Blvd E Ste 203, Puyallup, WA 98374-8847 | 2015-05-21 |
| 1740688902 | Oot Specialists of Puget Sound, Ps | Podiatrist | 2728 E Main Ave Suite A, Puyallup, WA 98372 | 2014-12-19 |
| 1932507191 | & Foot Specialists of Puget Sound, Ps | Podiatrist | 4140 Factoria Blvd Se Suite 1b, Bellevue, WA 98006 | 2014-12-19 |
| 1013313949 | Ankle & Foot Specialists of Puget Sound, Ps | Podiatrist | 17700 Se 272nd St Ste 370, Covington, WA 98042-4951 | 2014-11-04 |
| 1366869893 | Stephen J Wold II | Podiatrist | 16701 Ne Mcgillivray Blvd, Ste 220, Vancouver, WA 98683 | 2014-03-21 |
| 1194085043 | Sara Mahmood | Podiatrist | 1560 N 115th St Ste 102, Seattle, WA 98133-8414 | 2012-05-25 |
| Find all providers with the same taxonomy | ||||
| City | SPOKANE VALLEY |
| Zip Code | 99206 |
Please comment or provide details below to improve the information on DR. BRENT A 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.