Pamela M. Clark, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY60517271 Issued in WA

Practice address

3124 S Regal St
Spokane, WA 99223-4704

Phone

(509) 464-6208

NPI assigned

Oct 25, 2006

Sex

Female

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: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northwest Spine and Pain Medicine PLLCGroup PAC ID 5799972212, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Northwest Spine and Pain Medicine, PLLC

  • Multi-Specialty Clinic/Center
  • Spokane, WA
  • NPI 1669789228

  WA

  Medicare reassignment Care Compare group NPD
• Rare Wellness

  • Integrative Medicine Physician
  • Spokane, WA
  • NPI 1164148748
  NPD
• Selkirk Interventional Pain Physicians PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Spokane, WA
  • NPI 1780965186
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1730264334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3124 S REGAL ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992234704",
            "telephone_number": "509-464-6208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3124 S REGAL ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992234704",
            "telephone_number": "509-464-6208"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 S Cowley St",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992021330",
            "country_code": "US",
            "telephone_number": "949-473-6926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "PAMELA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY60517271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Kristin Clark, MD
• Matthew Ray Clark
• Michael Thomas Clark, PT, DPT
• Nathan Scott Clark, DO
• Nicole Clark, MS, CMC
• Peter James Clark, ATC, AT-L, CSCS, MA
• Rina Clark, LMP
• Sara M Clark, MD
• Shirlee Clark
• Sunshine Elisabeth Clark, PHD

• All providers in Spokane, WA
• Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; 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.