Individual provider Active NPI

Clarke St.Dennis, RPH, PHD, BCPP

  • Psychiatric Pharmacist
  • Medical Lake, WA
National Provider Identifier
1063492775
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric PharmacistTaxonomy code 1835P1300X
License
PH00009320 Issued in WA
Practice address
850 West Maple Street
Eastern State Hospital
Medical Lake, WA 99022
Phone
(509) 299-4466
NPI assigned
Jan 19, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Pharmacist 1835P1300X PH00009320 WA Primary

Addresses

Primary practice location

850 West Maple Street
Eastern State Hospital
Medical Lake, WA 99022

Mailing address

1421 S Kahuna Dr
Spokane Valley, WA 99212-3243
Phone (509) 220-9326

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PH00009320WAMDPsychiatric Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1063492775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 S KAHUNA DR",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992123243",
            "telephone_number": "509-220-9326",
            "fax_number": "509-358-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 WEST MAPLE STREET",
            "address_2": "EASTERN STATE HOSPITAL",
            "city": "MEDICAL LAKE",
            "state": "WA",
            "postal_code": "99022",
            "telephone_number": "509-299-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST.DENNIS",
        "first_name": "CLARKE",
        "name_prefix": "Dr.",
        "credential": "RPH, PHD, BCPP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1300X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Psychiatric",
            "state": "WA",
            "license": "PH00009320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medical Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.