Mark Justin Clary, LMP

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA60439284 Issued in WA

Practice address

8294 28TH CT NE Ste 100
Lacey, WA 98516-7140

Phone

(360) 951-9211

NPI assigned

Apr 28, 2016

Sex

Male

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

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

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461801600000",
    "number": "1427403369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 W INSELS RD",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985849167",
            "telephone_number": "360-951-9211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8294 28TH CT NE STE 100",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985167140",
            "telephone_number": "360-951-9211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARY",
        "first_name": "MARK",
        "middle_name": "JUSTIN",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-28",
        "last_updated": "2016-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA60439284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jim Clark
• Julianne Clark
• Lindsey Clark
• Shelby Linnette Clark
• Clarus Optical, LLC
• Kayla Marie Clauson, ATC
• Ann Clawson, PHD
• Emily C Clay, M.D.
• Renee Cheree Claybon, ARNP
• Kelsey R Clevenger, DC

• Specialist in Lacey, WA
• Providers in Lacey, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; 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.