Terry Robert Clark, PHARM D

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH00010513 Issued in WA

Practice address

402 S 4TH Ave Ste E127
Yakima, WA 98902-3546

Phone

(509) 899-4892

NPI assigned

Oct 28, 2005

Last updated

Mar 7, 2023By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1245221324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17741 MANASTASH RD",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989269119",
            "telephone_number": "509-962-2812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 S 4TH AVE STE E127",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023546",
            "telephone_number": "509-899-4892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TERRY",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2023-03-07",
        "certification_date": "2021-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00010513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PH00010513",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holly Clark, PHARMD
• Jeffrey Scott Clark, LMHC
• Jenatte Virginia Clark, ARNP
• Leah Eve Clark, LMT
• Mike L Clark, DDS
• Carolynn Kathleen Clarke, CNM, MSN, RN
• Kirsten Oversby Clarke, DPT
• Sean F Cleary, MD
• Michael Clement, MS, CDP
• Amanda Cathleen Clemmons, PA-C

• Pharmacist in Yakima, WA
• Providers in Yakima, WA by specialty
• Pharmacist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.