David Nicholas Clark, PT,DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT60865775 Issued in WA

Practice address

1010 S Scheuber Rd
Centralia, WA 98531-8892

Phone

(360) 480-1506

NPI assigned

Apr 1, 2019

Last updated

Apr 1, 2019By the provider in NPPES

Sex

Male

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1164984134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 ALTA ST SW APT D202",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985026103",
            "telephone_number": "503-707-9541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 S SCHEUBER RD",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985318892",
            "telephone_number": "360-480-1506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DAVID",
        "middle_name": "NICHOLAS",
        "credential": "PT,DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-01",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60865775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila Ann Cichoski, LMP
• Silvia Vianney Cisneros Campos, INTERPRETER
• Kaila R Cisneros Sanchez
• Miguel Cisneros Sanchez
• Allison Clark, LMP
• Jerry Dean Clark, SUDP, CPSS
• Shonna Clark, AAC
• Regine Claude
• Richard Emery Clevenger Jr., BA,AAC
• Ryan Coleman, CPSST

• Physical Therapist in Centralia, WA
• Providers in Centralia, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; 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.