Active NPI
Linda Patricia Clark, LMP
- Massage Therapist
- Orting, WA
National Provider Identifier
1679610927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA00004428
- Practice address
- 14610 229TH Ave E
Orting, WA 98360-9669 - Phone
- (253) 307-7227
- NPI assigned
- Jan 30, 2007
- Last updated
- Feb 26, 2018
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA00004428 | WA | Primary |
Addresses
Primary practice location
14610 229TH Ave E
Orting, WA 98360-9669
Mailing address
PO Box 1284
Orting, WA 98360-1284
Phone (253) 307-7227
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7694CL | Other | WA | REGENCE RIDER NUMBER |
| 66473 | Other | WA | L&I NUMBER |
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 |
|---|---|---|---|
| MA00004428 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519603200000",
"number": "1679610927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1284",
"city": "ORTING",
"state": "WA",
"postal_code": "983601284",
"telephone_number": "253-307-7227",
"fax_number": "360-897-6163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14610 229TH AVE E",
"city": "ORTING",
"state": "WA",
"postal_code": "983609669",
"telephone_number": "253-307-7227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "LINDA",
"middle_name": "PATRICIA",
"name_prefix": "Mrs.",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-30",
"last_updated": "2018-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00004428",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE RIDER NUMBER",
"identifier": "7694CL",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I NUMBER",
"identifier": "66473",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orting, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.