Rebecka Marie Clark, RDH, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA61212380 Issued in WA

Practice address

5609 74TH Dr NE
Marysville, WA 98270-8898

Phone

(360) 447-8831

NPI assigned

Dec 11, 2019

Last updated

Aug 25, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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": "1576022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1427696327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5609 74TH DRIVE NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982708898",
            "telephone_number": "253-709-0066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5609 74TH DR NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982708898",
            "telephone_number": "360-447-8831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "REBECKA",
        "middle_name": "MARIE",
        "credential": "RDH, LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-11",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WA",
            "license": "DH60556285",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA61212380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Marysville",
            "affiliation": "N",
            "endpointDescription": "home",
            "address_1": "Various",
            "city": "marysville",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982709827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Aaron Bernard Cilwa, LMHC, SUDP, CCMHC
• Carole A Clark, ARNP
• Harold G Clark, MD
• Nancy A Clark
• Nancy Ruth Clark
• Russell Adelbert Clark, DDS
• Shirley Clark, AS, RN
• Robert John Clarke, D.C.
• Bradley B Cleveland, PT
• Chad J. Cleven, DO

• Massage Therapist in Marysville, WA
• Providers in Marysville, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.