Active NPI
Dana Lynn Clark, SLPA
- Speech-Language Assistant
- Long Beach, WA
National Provider Identifier
1750620381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- SP 60198505
- Practice address
- 9303 Sandridge Rd
Long Beach, WA 98631-5102 - Phone
- (360) 642-0512
- NPI assigned
- Feb 1, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | SP 60198505 | WA | Primary |
Addresses
Primary practice location
9303 Sandridge Rd
Long Beach, WA 98631-5102
Mailing address
9303 Sandridge Rd
Long Beach, WA 98631-5102
Phone (360) 642-0512
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 |
|---|---|---|---|
| SP 60198505 | WA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359676800000",
"number": "1750620381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9303 SANDRIDGE RD",
"city": "LONG BEACH",
"state": "WA",
"postal_code": "986315102",
"telephone_number": "360-642-0512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9303 SANDRIDGE RD",
"city": "LONG BEACH",
"state": "WA",
"postal_code": "986315102",
"telephone_number": "360-642-0512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "DANA",
"middle_name": "LYNN",
"credential": "SLPA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-02-01",
"last_updated": "2013-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "WA",
"license": "SP 60198505",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.