Chase Nathanial Clark, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH60282066 Issued in WA

Practice address

20307 Viking Ave NW
Ste #102
Poulsbo, WA 98370

Phone

(360) 697-3737

Fax

(360) 779-6337

NPI assigned

Jun 8, 2012

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)

Enrolled

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

{
    "created_epoch": "1339113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480377600000",
    "number": "1447512231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20307 VIKING AVE NW",
            "address_2": "STE #102",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "98370",
            "telephone_number": "360-697-3737",
            "fax_number": "360-779-6337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20307 VIKING AVE NW",
            "address_2": "STE #102",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "98370",
            "telephone_number": "360-697-3737",
            "fax_number": "360-779-6337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHASE",
        "middle_name": "NATHANIAL",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-08",
        "last_updated": "2016-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60282066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Michael Christy, N.D., L.A.E.M.P.
• Sally Ann Christy
• Andrea A. Chun, M.D.
• Chymiymattymd LLC
• CJM Consulting LLC
• Jonna Clark, MS, OTR/L
• Alicia McKenna Cole, P.T.
• Jeremy Rossa Cole, LCSW
• Ann Michelle Collins
• Judith Glass Collins, PHD

• Chiropractor in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.