Mary S Clark, R.D, C.D.E

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DI00000724 Issued in WA

Practice address

2000 Hospital Dr
Sedro Woolley, WA 98284-4327

Phone

(360) 856-6021

Fax

(360) 856-7300

NPI assigned

May 24, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Skagit County Public Hospital District No 304

  • Diagnostic Radiology Physician
  • Sedro Woolley, WA
  • NPI 1609973007
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292284800000",
    "number": "1033320965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 HONEYSUCKLE DR",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982736623",
            "telephone_number": "360-424-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 HOSPITAL DR",
            "city": "SEDRO WOOLLEY",
            "state": "WA",
            "postal_code": "982844327",
            "telephone_number": "360-856-6021",
            "fax_number": "360-856-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MARY",
        "middle_name": "S",
        "credential": "R.D, C.D.E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2010-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI00000724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robyn Margot Choffel, ARNP
• Alishia Dyann Chory
• Christine Johnson, D.D.S.
• City of Sedro Woolley
• Barbara Joan Clark, RN61149827
• Angela J. Clements, PA-C
• Joann Marie Clemo, MSW, LICSW
• Tamhas Rob Clinton
• Walter William Coburn I
• Mindy Cocchiarella, ARNP FNP-C

• Registered Dietitian in Sedro Woolley, WA
• Providers in Sedro Woolley, WA by specialty
• Registered Dietitian in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.