Thomas Bennett Clark Jr., CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

AP60093669 Issued in WA

Practice address

1959 NE Pacific St
Seattle, WA 98195-0001

Phone

(206) 520-5000

NPI assigned

Nov 13, 2006

Last updated

Aug 15, 2024By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Washington Gastroenterology PLLCGroup PAC ID 6204194848, 142 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

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.

• Washington Gastroenterology PLLC

  • Gastroenterology Physician
  • Tacoma, WA
  • NPI 1306364401

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Gastroenterology Associates Clinical Practice, PLLC

  dba Gastroenterology Associates

  • Gastroenterology Physician
  • Olympia, WA
  • NPI 1811556442

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Narrows Surgery Center PS

  • Ambulatory Surgical Clinic/Center
  • Tacoma, WA
  • NPI 1093449225
  Medicare reassignment NPD
• Yakima Valley Memorial Physicians

  • General Acute Care Hospital
  • Yakima, WA
  • NPI 1306933940
  Medicare reassignment NPD
• Franciscan Medical Group

  dba Franciscan Orthopedics-Silverdale

  • Orthopaedic Surgery Physician
  • Silverdale, WA
  • NPI 1093165334
  NPD
• Narrows Surgery Center PS

  • Anesthesiology Physician
  • Tacoma, WA
  • NPI 1033974530

  Nurse Anesthetist, Certified Registered

  NPD
• Washington Gastroenterology PLLC

  dba Washington Gastroenterology Lab

  • Clinical Medical Laboratory
  • Federal Way, WA
  • NPI 1467011122
  NPD
• Yakima Valley Memorial Physicians

  • Orthopaedic Surgery Physician
  • Yakima, WA
  • NPI 1154015592
  NPD
• Yakima Valley Memorial Physicians

  • Durable Medical Equipment & Medical Supplies
  • Yakima, WA
  • NPI 1366325870
  NPD
• Narrows Anesthesia Services PLLC

  • Anesthesiology Physician
  • Tacoma, WA
  • NPI 1801026315

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1245301894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "206-520-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1717 S J St",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984054933",
            "country_code": "US",
            "telephone_number": "253-426-6341",
            "fax_number": "253-426-6344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "THOMAS",
        "middle_name": "BENNETT",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP60093669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2010101",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tclark857382@fhsce.catholichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1717 S J St",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984054933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sarah Clark, M.D.
• Sashya Clark
• Tabetha Clark
• Tara W. Clark, SLP
• Theresa-Ann Clark, MD
• Wendy Clark, AAC
• Hannah Verlie Clarke
• Julian Vukovich Clarke, MD
• Justin Eric Clarke, LMHC
• Merith Clarke, PEER SPECIALIST

• Certified Registered Nurse Anesthetist in Seattle, WA
• Providers in Seattle, WA by specialty
• Certified Registered Nurse Anesthetist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.