Becky Ann Clark, B.S., P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00000849 Issued in WA

Practice address

12012 E Mission Ave
Spokane Valley, WA 99206-4887

Phone

(509) 413-1630

Fax

(509) 413-1673

NPI assigned

Mar 23, 2006

Last updated

Apr 9, 2012By the provider in NPPES

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

Other names 1

• Rebecca Ann Clark Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science

Practice roles

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

• Apex Physical Therapy PLLC

  • Physical Therapist
  • Spokane, WA
  • NPI 1538128442
  NPD (past)

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333929600000",
    "number": "1225098411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21525 N LITTLE SPOKANE DR",
            "city": "COLBERT",
            "state": "WA",
            "postal_code": "990059478",
            "telephone_number": "509-466-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12012 E MISSION AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992064887",
            "telephone_number": "509-413-1630",
            "fax_number": "509-413-1673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "BECKY",
        "middle_name": "ANN",
        "credential": "B.S., P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2012-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00000849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0108459",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7076995",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "CLARK",
            "middle_name": "ANN",
            "credential": "BS, P.T.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Christopher Stephen Woodard, DMD, PLLC
• Lindsey Christopherson
• Tyese-Andreya A Chumov, LMT
• Carin M Chynoweth, PTA
• Paden Cipolla-Crane
• Erin A Clark
• Isabella Kae Clark, RN
• Jay Regan Clark, DDS
• Jessica Blanche Clark, LMT
• Rebecca June Clark, LMP

• Physical Therapist in Spokane Valley, WA
• Providers in Spokane Valley, 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 9, 2012; 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.