Erica Lynne Clark, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00006742 Issued in WA

Practice address

9311 SE 36TH St Ste 208
Mercer Island, WA 98040-3741

Phone

(206) 402-6339

Fax

(206) 456-2551

NPI assigned

Dec 5, 2005

Last updated

Jul 26, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bridge Physical Therapy and WellnessGroup PAC ID 4688052467, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bridge Physical Therapy and Wellness

  • Physical Therapist
  • Mercer Island, WA
  • NPI 1366185316
  Medicare reassignment Care Compare group NPD
• Therapeutic Associates Inc

  dba TAI - North Creek

  • Physical Therapist
  • Bothell, WA
  • NPI 1114376563
  NPD (past)
• Therapeutic Associates Inc

  dba TAI Cedar Hills Physical Therapy

  • Physical Therapist
  • Portland, OR
  • NPI 1700862000
  NPD (past)

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1407830359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7228 W MERCER WAY",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980405572",
            "telephone_number": "206-954-6936",
            "fax_number": "206-456-2551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9311 SE 36TH ST STE 208",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980403741",
            "telephone_number": "206-402-6339",
            "fax_number": "206-456-2551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4701 41st Ave SW",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981164597",
            "country_code": "US",
            "telephone_number": "206-932-8363",
            "fax_number": "206-932-8363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ERICA",
        "middle_name": "LYNNE",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-05",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00006742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Samra Cho
• Nakyung Choe, ARNP
• Samuel Chong, DDS
• City of Mercer Island
• City of Mercer Island (Mercer Island Fire Department)
• Tumaini Rucker Coker, M.D.
• Paul Dewitt Conrad, M.D.
• Cormedical, Inc.
• Jillian Clarke Correa
• Covenant Living West (Covenant Shores Health Center)

• Physical Therapist in Mercer Island, WA
• Providers in Mercer Island, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.