Matthew Clark

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP61636762 Issued in WA

Practice address

PO Box 257
Olympia, WA 98507-0257

Phone

(206) 208-8957

NPI assigned

Jul 24, 2025

Sex

Unspecified or another gender identity

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

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: matthew.clark.1@24259.direct.athenahealth.com

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.

• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment NPD
• Domain Psychiatry, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Seattle, WA
  • NPI 1902779796
  NPD Authorized official
• Harbor Youth and Family Counseling

  • Mental Health Counselor
  • Tukwila, WA
  • NPI 1205466265
  NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Multicare Health System

  • Community/Behavioral Health Agency
  • Auburn, WA
  • NPI 1861872178
  NPD

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

{
    "created_epoch": "1753315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1689556201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 257",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985070257",
            "telephone_number": "206-208-8957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 257",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985070257",
            "telephone_number": "206-208-8957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-07-24",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61636762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlotte Barbara Clark-Neitzel, MD
• Alyssa Compton Clark
• Ashleigh L Clark, BA, CDPT
• Cary Ann Clark
• Daniel W Clark, PHD
• Phillip J Clark
• John A Clarke, R.PH.
• Joanne M Clarkson, RN
• Amanda Nicole Clauson, CNM, ARNP
• Egypt Claxton

• Psychiatric/Mental Health Nurse Practitioner in Olympia, WA
• Providers in Olympia, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.