CANDACE CLARK (NPI# 1609297431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609297431 |
| Entity Type | Individual |
| Full Name | CANDACE CLARK |
| Credential | RD, CD, CDE |
| Practice Address |
1615 Delware Street Longview WA 98632 |
| Mailing Address |
1615 Delware Street P.o. Box 3002 Longview WA 98632 |
| Practice Telephone | 3604142000 |
| Mailing Telephone | 3604142000 |
| Enumeration Date | 2013-12-20 |
| Last Update Date | 2013-12-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | DI 60269049 | WA | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376166579 | Candace Ann Clark | Physician Assistant | 7237 Wellauer Dr, Wauwatosa, WI 53213-3665 | 2020-05-21 |
| 1821448820 | Candace Clark | Clinic/Center | 17008 Sw 39th St, Miramar, FL 33027-4614 | 2016-06-21 |
| 1437775095 | Candace Danielle Clark | Counselor | 4211 Government Blvd, Mobile, AL 36693-4813 | 2020-06-19 |
| 1619534203 | Candace Clark | Social Worker | 13136 Western Ave, Blue Island, IL 60406-2423 | 2019-05-20 |
| 1629327101 | Candace Clark | Counselor | 202 East Bagley Road, Berea, OH 44017-2058 | 2012-08-30 |
| Street Address |
1615 DELWARE STREET |
| City | LONGVIEW |
| State | WA |
| Zip Code | 98632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992366 | Honor Senior Care LLC | Home Health Aide | 1135 3rd Ave, Ste S101, Longview, WA 98632 | 2020-11-03 |
| 1417416728 | Sam Wise | Dentist | 1538 11th Ave Lowr Columbia, Longview, WA 98632 | 2019-03-16 |
| 1053870717 | Matthew Johnson | Physician Assistant | 900 Ocean Beach Hwy Ste 110, Longview, WA 98632 | 2019-03-12 |
| 1295205367 | Abid Valji | Occupational Therapist | Americana Health and Rehabilitation Center, 917 7th Ave, Longview, WA 98632 | 2018-11-30 |
| 1184106437 | Peacehealth | Durable Medical Equipment & Medical Supplies | Triangle Mall Suite 16 1015 Ocean Beach Hwy, Longview, WA 98632 | 2018-09-04 |
| 1982186318 | Linda Joan Mason | Licensed Practical Nurse | 1153 23rd Ave, Longview, WA 98632 | 2018-09-01 |
| 1891291910 | Ellen Sumner Hornbeak | Physical Therapist | 200 Triangle Shopping Ctr Ste 270, Longview, WA 98632 | 2018-04-05 |
| 1700399961 | Johnna Joyce Knapp | Speech-Language Pathologist | 2615 Lilac St, Longview, WA 98632 | 2017-11-09 |
| 1841711868 | Deborah Annette Burzynski | Registered Nurse | 1057 12th Avenue, Longview, WA 98632 | 2017-06-29 |
| 1598291122 | Cheyenne West | Counselor | 1616 10th Avenue, Longview, WA 98632 | 2017-05-02 |
| Find all providers in zip 98632 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760030456 | Stephanie Michelle Michael | Dietitian, Registered | 615 7th Ave # 17, Longview, WA 98632-1606 | 2019-08-27 |
| 1417447624 | Danyelle Bloomstrom | Dietitian, Registered | 600 Broadway St Ste 120, Longview, WA 98632-3256 | 2018-05-14 |
| 1659638963 | Stefanie Lynn Wilkerson | Dietitian, Registered | 770 Dennard St, Longview, TX 75605-8295 | 2012-04-12 |
| 1659691095 | Kristina R Macher | Dietitian, Registered | 712 N High St, Longview, TX 75601-5330 | 2010-06-08 |
| 1770524621 | Pamela Dawn Hignight | Dietitian, Registered | 1205 E Marshall Ave, Longview, TX 75601-5649 | 2006-06-10 |
| 1952364234 | Mary Lynn Vassar | Dietitian, Registered | 2901 N 4th St, Longview, TX 75605-5128 | 2006-04-08 |
| 1427027739 | Denise Frye | Dietitian, Registered | 107 Woodbine Place, #775, Longview, TX 75608 | 2006-03-17 |
| 1023572351 | Kathleen Teresa Pittman | Dietitian, Registered | 1717 Olympia Way Ste 206, Longview, WA 98632-3929 | 2019-01-31 |
| 1619471505 | Susan Hughes | Dietitian, Registered | 1005 N Eastman Rd, Longview, TX 75601-4231 | 2018-03-23 |
| 1255789152 | Erika Jeanne Luther | Dietitian, Registered | 1615 Delaware St, Longview, WA 98632-2367 | 2016-06-01 |
| Find all providers in LONGVIEW | ||||
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| 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.