Laurel Megan Clark, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60756541 Issued in WA

Practice address

410 E 20TH St
Vancouver, WA 98663-3316

Phone

(360) 931-0976

NPI assigned

May 24, 2017

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Theology

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.

• Fern & Fae Massage

  • Massage Therapist
  • Vancouver, WA
  • NPI 1255038295
  NPD (past) Authorized official
• Davis Family Chiropractic, PLLC

  • Chiropractor
  • Vancouver, WA
  • NPI 1720252232
  NPD (past)

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

{
    "created_epoch": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1114455979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 W 30TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986602129",
            "telephone_number": "360-931-0976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 E 20TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986633316",
            "telephone_number": "360-931-0976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LAUREL",
        "middle_name": "MEGAN",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-24",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60756541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMTA MEMBERSHIP",
            "identifier": "1409013",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE LICENSE",
            "identifier": "MA60756541",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey M Clark, PA-C
• Julie A. Clark, BSN, RN
• Kathryn Clark, AAC
• Katie Clark
• Laura Marie Clark, MSW, MA
• Mark W Clark, PSY.D.
• Misty Noel Clark, RN
• Nicolas Clark, CBT70128252
• Richard Clark
• Robert Lee Clark, MS

• Massage Therapist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; 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.