Individual provider Active NPI

Rebecca Clark

  • Genetic Counselor (M.S.)
  • Portland, OR
National Provider Identifier
1285025619
Registry record updated Feb 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Genetic Counselor (M.S.)Taxonomy code 170300000X
Practice address
9555 SW Barnes Rd
Suite 150
Portland, OR 97225-6663
Phone
(503) 297-7403
Fax
(503) 384-9908
NPI assigned
Feb 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Genetic Counselor (M.S.) 170300000X OR Primary

Addresses

Primary practice location

9555 SW Barnes Rd
Suite 150
Portland, OR 97225-6663

Mailing address

9555 SW Barnes Rd
Suite 150
Portland, OR 97225-6663
Phone (503) 297-7403

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

Interoperability endpoints

  • Direct secure messaging: rebecca.clark@compass.ikm.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1423180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423180800000",
    "number": "1285025619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9555 SW BARNES RD",
            "address_2": "SUITE 150",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256663",
            "telephone_number": "503-297-7403",
            "fax_number": "503-384-9908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9555 SW BARNES RD",
            "address_2": "SUITE 150",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256663",
            "telephone_number": "503-297-7403",
            "fax_number": "503-384-9908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "REBECCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-06",
        "last_updated": "2015-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2015; 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.