Richard D Clarke, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

AP30004891 Issued in WA

Practice address

400 S 3Rd St
Renton, WA 98055-2026

Phone

(425) 353-3788

Fax

(425) 353-8041

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329696000000",
    "number": "1417069451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84571",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981245871",
            "telephone_number": "425-353-3788",
            "fax_number": "425-353-8041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S 3RD ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980552026",
            "telephone_number": "425-353-3788",
            "fax_number": "425-353-8041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "RICHARD",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP30004891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0153530",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9631946",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clark Chiropractic Clinic
• Clark Chiropractic Inc
• Clark Chiropractic Inc
• Savannah Clark, LMT
• Theodore Jeffrey Clark, D.C.
• Classic Cabulance LLC
• Clearly Lasik, Inc.
• Margaret H Clements, MD
• Cleopatra Rejuvenation Clinic, PLLC
• Seth Clewley

• Certified Registered Nurse Anesthetist in Renton, WA
• Providers in Renton, WA by specialty
• Certified Registered Nurse Anesthetist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; 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.