Active NPI
Christina Lynn Clark, RPH
- Pharmacist
- Bonney Lake, WA
National Provider Identifier
1265733489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH00020225
- Practice address
- 21301 State Route 410 E
Bonney Lake, WA 98391-8468 - Phone
- (253) 862-2533
- NPI assigned
- Nov 4, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH00020225 | WA | Primary |
Addresses
Primary practice location
21301 State Route 410 E
Bonney Lake, WA 98391-8468
Mailing address
21301 Hwy 410 East
Bonney Lake, WA 98391
Phone (253) 862-2533
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH00020225 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288828800000",
"number": "1265733489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21301 HWY 410 EAST",
"city": "BONNEY LAKE",
"state": "WA",
"postal_code": "98391",
"telephone_number": "253-862-2533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21301 STATE ROUTE 410 E",
"city": "BONNEY LAKE",
"state": "WA",
"postal_code": "983918468",
"telephone_number": "253-862-2533"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "CHRISTINA",
"middle_name": "LYNN",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-04",
"last_updated": "2010-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00020225",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bonney Lake, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.