Emma Jean Clark, LMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00028464 Issued in WA

Practice address

21907 64TH Ave. W
Suite # 110
Mountlake Terrace, WA 98043

Phone

(425) 673-5220

Fax

(425) 673-1597

NPI assigned

Jan 12, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mosaic Rehabilitation Inc.

  • Specialist
  • Bellevue, WA
  • NPI 1972790947
  NPD (past)
• Mosaic Rehabilitation, Inc

  • Rehabilitation Clinic/Center
  • Bellevue, WA
  • NPI 1659595593
  NPD (past)
• Pain Free Move Well

  • Chiropractor
  • Mountlake Terrace, WA
  • NPI 1568737047
  NPD (past)

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240876800000",
    "number": "1508917055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2445 140TH AVE. NE",
            "address_2": "SUITE B-105",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98005",
            "telephone_number": "425-644-6328",
            "fax_number": "425-644-6295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21907 64TH AVE. W",
            "address_2": "SUITE # 110",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "98043",
            "telephone_number": "425-673-5220",
            "fax_number": "425-673-1597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "EMMA",
        "middle_name": "JEAN",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2009-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00028464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda B Christenson
• Janeen Christian
• Edwin Chung
• Christine Alison Cirovic, N.D.
• Christine Parker Civello, MA, LPC-A
• Julie Anne Clark, CDP
• Tiffany Ann Classen, MA, LMFT
• John E Clavadetscher, O.D.
• Caitlin Clements, B.A.
• Cloud 9 Anesthesia, LLC

• Massage Therapist in Mountlake Terrace, WA
• Providers in Mountlake Terrace, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2009; 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.