Clark Golden Dalton, MHS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL60492790 Issued in WA

Practice address

801 E Wheeler Rd
Moses Lake, WA 98837-1820

Phone

(509) 793-9605

Fax

(509) 764-3203

NPI assigned

Jul 19, 2013

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1374192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1720420656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S COOLIDGE ST",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371872",
            "telephone_number": "509-793-9715",
            "fax_number": "509-764-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E WHEELER RD",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371820",
            "telephone_number": "509-793-9605",
            "fax_number": "509-764-3203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 E Nelson Rd",
            "address_purpose": "LOCATION",
            "city": "Moses Lake",
            "state": "WA",
            "postal_code": "988372360",
            "country_code": "US",
            "telephone_number": "509-765-6788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DALTON",
        "first_name": "CLARK",
        "middle_name": "GOLDEN",
        "credential": "MHS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-19",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL60492790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Moses Lake, WA
• Providers in Moses Lake, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; 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.