Gina Clark, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

60194 Issued in OR

Practice address

551 Lone Pine Blvd
The Dalles, OR 97058-9403

Phone

(541) 296-7202

NPI assigned

Jan 8, 2014

Last updated

Apr 18, 2016By 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

Other names 1

• Gina Safaty Former name

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": "1389139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460937600000",
    "number": "1427470558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5455 HIGHWAY 35",
            "city": "MOUNT HOOD PARKDALE",
            "state": "OR",
            "postal_code": "970417744",
            "telephone_number": "503-504-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 LONE PINE BLVD",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970589403",
            "telephone_number": "541-296-7202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "GINA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-08",
        "last_updated": "2016-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "60194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "SAFATY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael Child
• Zachary Chown, P.T.
• Andrea J Chrisman
• Brandon Thomas Christian
• Brandi Denise Clark
• Natalie Clark, PA-C
• Kaitlen Clarke, PT, DPT
• Clear Choice Dermatology (The Skin Docs)
• Heather Clemence, QMHP
• Cassandra Cleveland

• Physical Therapist in The Dalles, OR
• Providers in The Dalles, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.