MRS. DIANE K CLARK (NPI# 1881863488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881863488 |
| Entity Type | Individual |
| Full Name | MRS. DIANE K CLARK |
| Credential | ACNP |
| Practice Address |
9427 Sw Barnes Rd Ste 595 Portland OR 97225-6640 |
| Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
| Practice Telephone | 5032161150 |
| Mailing Telephone | 5032156494 |
| Mailing Fax Number | 5032156644 |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2016-05-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 201150003NP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
201150003NP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
278877-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SC0200X |
Clinical Nurse Specialist Specialization: Critical Care Medicine |
278877-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | RR MEDICARE | P00957594 | 01 |
| OR | 500631611 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841767449 | Diane Clark | Registered Nurse | 8219 Golden Hbr, Missouri City, TX 77459-6905 | 2018-11-01 |
| 1669612644 | Diane M Clark | Counselor | 1557 Brandon Sq, Lawrenceville, GA 30044-3016 | 2009-03-03 |
| 1922563139 | Diane Faith Clark | Psychologist | 25631 Peter A Hartman Way, Mission Viejo, CA 92691-3142 | 2019-02-01 |
| 1952763377 | Diane Clark | Registered Nurse | 1118 F St, Lewiston, ID 83501-1930 | 2016-03-24 |
| 1225419096 | Diane Clark | Social Worker | 1115 Westport Dr Ste D2, Manhattan, KS 66502-2871 | 2015-06-17 |
| 1164832887 | Diane Clark | Counselor | 233 S Quintana Dr, Anaheim, CA 92807 | 2014-05-02 |
| 1558634980 | Diane Clark | Pharmacist | 3639 Crater Lake Hwy, Medford, OR 97504-9259 | 2012-02-15 |
| 1841406261 | Diane E. Clark | Counselor | 200 Washington St, Suite 205, Watertown, NY 13601-3335 | 2007-05-15 |
| 1306994637 | Diane Marie Clark | Chiropractor | 4705 S Clyde Morris Blvd, Port Orange, FL 32129-4103 | 2007-01-05 |
| 1306941166 | Diane Maxine Clark | Physical Therapist | 13560 Wayzata Blvd, Minnetonka, MN 55305-1850 | 2006-09-14 |
| Street Address |
9427 SW BARNES RD STE 595 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225-6640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407851363 | Bernard A Gasch | Dermatology | 9427 Sw Barnes Rd, Suite 495, Portland, OR 97225-6652 | 2005-06-16 |
| 1316473564 | Providence | General Acute Care Hospital | 9427 Sw Barnes Rd, Sutie 295, Portland, OR 97225 | 2017-05-10 |
| 1316318124 | Jun-nicole Matsushita | Doula | 9427 Sw Barnes Rd, Suite 395, Portland, OR 97225-6652 | 2015-10-20 |
| 1457759318 | Providence Health & Services - Oregon | Pediatrics | 9427 Sw Barnes Rd, Ste 395, Portland, OR 97225-6652 | 2014-12-09 |
| 1912324963 | Transitional Care Alliance | Nurse Practitioner | 9427 Sw Barnes Rd, Portland, OR 97225-6652 | 2014-03-27 |
| 1760818447 | Meegan Marie Mangum | Physician Assistant | 9427 Sw Barnes Rd, Suite 498, Portland, OR 97225-6652 | 2013-09-25 |
| 1083059778 | Providence Health & Services - Oregon | Obstetrics & Gynecology | 9427 Sw Barnes Rd, Suite 599, Portland, OR 97225-6652 | 2013-05-08 |
| 1912341108 | Emmanuel Rey Ariola | Registered Nurse | 9427 Sw Barnes Rd, Suite 495, Portland, OR 97225-6652 | 2013-04-18 |
| 1023359213 | Cheri Lynn Belling | Nurse Practitioner | 9427 Sw Barnes Rd, Suite 595, Portland, OR 97225-6652 | 2013-03-13 |
| 1639436074 | Alison Christy | Psychiatry & Neurology | 9427 Sw Barnes Rd, Suite 395, Portland, OR 97225-6652 | 2012-04-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508425034 | Gabrielle Gonzales | Behavior Technician | 1675 Sw Marlow Ave, Suite 200, Portland, OR 97225 | 2019-06-08 |
| 1558844555 | Tate Roseberry | Behavior Technician | 1675 Sw Marlow Avenue, Suite 200, Portland, OR 97225 | 2018-09-14 |
| 1982186300 | Dean Alan Hopkins | Registered Nurse | 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225 | 2018-09-01 |
| 1316449168 | Surgery Center At St. Vincent, LLC | Clinic/Center | 9135 Sw Barnes Rd Ste 161, Portland, OR 97225 | 2018-03-07 |
| 1730606716 | Meghan Louise Lacy | Pediatrics | 11790 Sw Barnes Rd, Blg. A, Suite 140, Portland, OR 97225 | 2017-08-29 |
| 1841733433 | Tia Pugh | Occupational Therapist | 9155 S.w. Barnes Road, East Pavilion, Portland, OR 97225 | 2016-11-30 |
| 1295185585 | Stephanie Lynn Hart | Nurse Practitioner | 9155 Sw Barnes Rd Ste 240, Portland, OR 97225 | 2016-06-16 |
| 1962866244 | Bejian Shamloo | Chiropractor | 10200 Sw Eastridge St., Suite 235, Portland, OR 97225 | 2016-04-12 |
| 1992162630 | Robert Joseph Yoder | Psychologist | 9045 Barnes Rd, Portland, OR 97225 | 2016-01-26 |
| 1316303951 | Katie Herold | Chiropractor | 9315 Sw Morrison St, Portland, OR 97225 | 2016-01-12 |
| Find all providers in zip 97225 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588136295 | Tao Wang | Nurse Practitioner | 38 Michele Dr, Portland, CT 06480-1013 | 2018-12-19 |
| 1679041115 | Kendra Kathryn Mundstock | Nurse Practitioner | 3181 Sw Sam Jackson Park Rd # 13k, Portland, OR 97239-3011 | 2018-11-02 |
| 1043786551 | Lindsey Forleo | Nurse Practitioner | 22 Bramhall St Rm 4670, Portland, ME 04102-3134 | 2018-10-23 |
| 1659801785 | Christine Haboush | Nurse Practitioner | 6015 Ne Skidmore St, Portland, OR 97218-2225 | 2017-06-12 |
| 1386042315 | Jessica Mayer | Nurse Practitioner | 122 Se 80th Ave, Portland, OR 97215-1522 | 2014-12-08 |
| 1376814095 | Paula Claire Havelin | Nurse Practitioner | 235 Highway 52 W, Portland, TN 37148-1407 | 2012-01-26 |
| 1417284175 | Derek Neil Bowers | Nurse Practitioner | 2836 Ne Bryce St, Portland, OR 97212-1640 | 2009-11-17 |
| 1982820692 | Hilary Anne Shreves | Nurse Practitioner | 3303 Sw Bond Ave Ste 10, Portland, OR 97239-4501 | 2007-04-18 |
| 1588691117 | Emily Tidwell | Nurse Practitioner | 421 N Broadway, Portland, TN 37148-1750 | 2006-06-27 |
| 1639174287 | Dawn F. Tilgner | Nurse Practitioner | 3303 Sw Bond Ave, Portland, OR 97239-4501 | 2005-06-19 |
| Find all providers in PORTLAND | ||||
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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.