Tylee Cooper Clark, CSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

A15351 Issued in OR

Practice address

11740 SW 68TH Pkwy Ste 200
Tigard, OR 97223-9058

Phone

(425) 477-4216

Fax

(971) 352-6984

NPI assigned

Sep 15, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1043825169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 COVE AVE",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978503906",
            "telephone_number": "541-962-8800",
            "fax_number": "541-963-5272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11740 SW 68TH PKWY STE 200",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972239058",
            "telephone_number": "425-477-4216",
            "fax_number": "971-352-6984"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Cove Ave",
            "address_purpose": "LOCATION",
            "city": "LA Grande",
            "state": "OR",
            "postal_code": "978503906",
            "country_code": "US",
            "telephone_number": "541-962-8800",
            "fax_number": "541-963-5272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TYLEE",
        "middle_name": "COOPER",
        "credential": "CSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-15",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": "A15351",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "A15351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis P Clark, DMD
• Erica Clark
• Kyra Clark
• Latorria Clark
• Madeline Clark
• Helen Katherine Clarke, OTR
• Susan Clarke, LMT
• Peggy Sue Clay
• Rebecca M Cleeton, DO
• Rebekah Dawn Clement

• Clinical Social Worker in Tigard, OR
• Providers in Tigard, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2026; 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.