Active NPI
Deborah Faye Clark
- Social Worker
- Seattle, WA
National Provider Identifier
1679034789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LW00005480
- Practice address
- 3006 E Cherry St
Seattle, WA 98122-5036 - Phone
- (206) 263-9000
- NPI assigned
- Mar 29, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LW00005480 | WA | Primary |
Addresses
Primary practice location
3006 E Cherry St
Seattle, WA 98122-5036
Mailing address
3006 E Cherry St
Seattle, WA 98122-5036
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LW00005480 | WA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553817600000",
"number": "1679034789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3006 E CHERRY ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981225036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3006 E CHERRY ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981225036",
"telephone_number": "206-263-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "DEBORAH",
"middle_name": "FAYE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-03-29",
"last_updated": "2019-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WA",
"license": "LW00005480",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.