Stacey J. Clarke DPM, PC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

DP00283 Issued in OR

Legal business name

STACEY J. CLARKE DPM, PC

Practice address

1408 N Hall St
La Grande, OR 97850-3807

Phone

(541) 963-0265

Fax

(541) 963-6176

NPI assigned

Mar 5, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Stacey J Clarke, DPM

Title

Owner

Phone

(541) 963-0265

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558490763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 N HALL ST",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978503807",
            "telephone_number": "541-963-0265",
            "fax_number": "541-963-6176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 N HALL ST",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978503807",
            "telephone_number": "541-963-0265",
            "fax_number": "541-963-6176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACEY J. CLARKE DPM, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-963-0265",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "OR",
            "license": "DP00283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150541",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zachary W Spoehr-Labutta, MD
• Aaron Lloyd Spracklen, DO
• Michelle Sprouffske, MSW, LCSW
• Sandra J Staab
• Stacey J. Clarke D.P.M., P.C.
• Troy Stebbins
• Jennifer Stecher
• Stephen M. McLean, D.M.D.,P.C.
• Roxanna Stephens, RN, CWON
• Steps to Change, LLC

• Podiatrist in La Grande, OR
• Providers in La Grande, OR by specialty
• Podiatrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.