Cara Aria Clark, CHW

Individual provider Active NPI Community Health Worker · Stayton, OR

NPI 1003687534 · NPPES record last updated Jan 12, 2024

Key facts

NPI
1003687534
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
License
TWH000110358 (OR)
Practice address
1401 N 10TH Ave
Stayton, OR 97383-1311
Phone
(971) 600-5847
NPI assigned
Jan 12, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
TWH000110358ORMDCommunity Health Worker
THW000107924ORMDPeer Specialist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X THW000107924 OR
Community Health Worker 172V00000X TWH000110358 OR Yes

Addresses

Primary practice location

1401 N 10TH Ave
Stayton, OR 97383-1311

Mailing address

1401 N 10TH Ave
Stayton, OR 97383-1311
Phone (971) 600-5847

Other providers in Stayton, OR

All providers in Stayton, OR · Community Health Worker in Oregon

Sources for this page

Verify at the official NPI Registry.