Active NPI
Hillary Whitaker Clark, PSY.D.
- Clinical Psychologist
- Lakewood, WA
National Provider Identifier
1386874147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY 60021419
- Practice address
- 10209 Bridgeport Way SW
Suite a-5
Lakewood, WA 98499-2320 - Phone
- (253) 581-1231
- Fax
- (253) 581-1232
- NPI assigned
- Jul 15, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY 60021419 | WA | Primary |
Addresses
Primary practice location
10209 Bridgeport Way SW
Suite a-5
Lakewood, WA 98499-2320
Mailing address
PO Box 99179
Lakewood, WA 98496-0179
Phone (360) 908-8491
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY 60021419 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360108800000",
"number": "1386874147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 99179",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984960179",
"telephone_number": "360-908-8491",
"fax_number": "253-581-1232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10209 BRIDGEPORT WAY SW",
"address_2": "SUITE A-5",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984992320",
"telephone_number": "253-581-1231",
"fax_number": "253-581-1232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "HILLARY",
"middle_name": "WHITAKER",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-15",
"last_updated": "2013-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY 60021419",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.