Joanne Clarke, ELECTROLOGIST

Primary specialty

TechnicianTaxonomy code 374700000X

License

BAP-E-10202403 Issued in OR

Practice address

723 SE Main Street
Roseburg, OR 97470-3938

Phone

(541) 760-8401

NPI assigned

Jan 7, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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 and National Provider Directory roles.

• Electrolysis and Esthetic by Joanne

  • Technician
  • Roseburg, OR
  • NPI 1528608288
  NPD Authorized official

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

{
    "created_epoch": "1578355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1386284339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1183 NW RIVERFRONT DR",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974716168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 SE MAIN STREET",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703938",
            "telephone_number": "541-760-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "JOANNE",
        "name_prefix": "Mrs.",
        "credential": "ELECTROLOGIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-07",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": "OR",
            "license": "BAP-E-10202403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Van Clark, LCSW
• Jayson Clark, MSMFT, LPC
• Julie Kolstad Clark
• Larry Dale Clark
• Sara Clark
• Linda Veronica Clarke, N.D.
• Randall Scott Clasen, L.D.
• Peter Clemens, DO
• Douglas Don Cleveland III
• Tyler Lee Cleveland

• Technician in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Technician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; 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.