Individual provider Active NPI

Annemieke Clark Emch, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Beaverton, OR
National Provider Identifier
1295239168
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
201805147NP-PP Issued in OR
Practice address
1500 NW Bethany Blvd Ste 200
Beaverton, OR 97006-5236
Phone
(503) 741-2735
Fax
(503) 308-7222
NPI assigned
Mar 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP60866557 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 201805147NP-PP OR Primary

Addresses

Primary practice location

1500 NW Bethany Blvd Ste 200
Beaverton, OR 97006-5236

Mailing address

1500 NW Bethany Blvd Ste 200
Beaverton, OR 97006-5236
Phone (503) 741-2735

Other practice location 1

8196 SW Hall Blvd Ste 319
Beaverton, OR 97008-4035
Phone (503) 741-2735

Other practice location 2

6700 SW 105th Ave Ste 303
Beaverton, OR 97008-8825
Phone (503) 741-2735

Other names 1

  • Annemieke Clark Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 1, 2025 through Apr 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201805147NP-PPORMDPsychiatric/Mental Health Nurse Practitioner
AP60866557WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Psychiatric Wellness LLC Psychiatric/Mental Health CurrentSince Jun 1, 2022 Accepting new patients

Locations

6700 SW 105th Ave
Ste 303
Beaverton, OR 97008
Phone (503) 741-2735

1500 NW Bethany Blvd
Ste 200
Hillsboro, OR 97006
Phone (503) 708-0523

15110 Boones Ferry Rd
Ste 248
Lake Oswego, OR 97035
Phone (503) 830-3215

4300 NE Fremont St
Ste 260
Portland, OR 97213
Phone (503) 544-9996

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1295239168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 NW BETHANY BLVD STE 200",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970065236",
            "telephone_number": "503-741-2735",
            "fax_number": "503-308-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 NW BETHANY BLVD STE 200",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970065236",
            "telephone_number": "503-741-2735",
            "fax_number": "503-308-7222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8196 SW Hall Blvd Ste 319",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970084035",
            "country_code": "US",
            "telephone_number": "503-741-2735",
            "fax_number": "503-308-7222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6700 SW 105th Ave Ste 303",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970088825",
            "country_code": "US",
            "telephone_number": "503-741-2735",
            "fax_number": "503-308-7222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EMCH",
        "first_name": "ANNEMIEKE",
        "middle_name": "CLARK",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-23",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60866557",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201805147NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNEMIEKE",
            "last_name": "CLARK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.