Clark College

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

PY60267694 Issued in WA

Legal business name

CLARK COLLEGE

Practice address

1933 Fort Vancouver Way
HSC 124
Vancouver, WA 98663-3529

Phone

(360) 992-2614

NPI assigned

Jun 8, 2014

Organization subpart

No

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

Authorized official

Name

Patricia Douglass, LICSW

Title

Clinical Supervisor

Phone

(360) 992-2614

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elizabeth Anne Hopper, ARNP

  • Family Nurse Practitioner
  • Tacoma, WA
  • NPI 1154524601
  NPD (past)

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

{
    "created_epoch": "1402185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402185600000",
    "number": "1285047258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1933 FORT VANCOUVER WAY",
            "address_2": "HSC 124",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986633529",
            "telephone_number": "360-992-2614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1933 FORT VANCOUVER WAY",
            "address_2": "HSC 124",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986633529",
            "telephone_number": "360-992-2614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK COLLEGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-08",
        "last_updated": "2014-06-08",
        "status": "A",
        "authorized_official_last_name": "DOUGLASS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "CLINICAL SUPERVISOR",
        "authorized_official_telephone_number": "360-992-2614",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WA",
            "license": "PY60267694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tabitha Lee Citrine, MSW, LSWAIC
• Cke Longevity LLC
• Chelsea Gene Clanton
• Suzanne Meradith Clanton, PSY.D.
• Darius Clardy
• Clark County Cab LLC
• Clark County Current Expense
• Clark County Current Expense & Clark County Auditors Office
• Clark County Dental & Denture Clinic
• Clark County Dental & Denture Clinic

• Community/Behavioral Health Agency in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Community/Behavioral Health Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.