Clark Therapeutic Massage
Organization Active NPI Massage Therapist · Graham, WA
NPI 1770620064 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1770620064
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Massage Therapist 225700000X
- License
- MA00004428 (WA)
- Legal business name
- CLARK THERAPEUTIC MASSAGE
- Practice address
- 10107 213TH St E
Graham, WA 98338-8059 - Phone
- (253) 847-2687
- Fax
- (253) 846-3012
- NPI assigned
- Jan 30, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Linda Patricia Clark, LMP
- Title
- Owner
- Phone
- (253) 847-2687
Practitioners 8
-
Jennie Bonfiglio, DC
-
John Patrick Kellogg, D.C.
-
Tedd M. Perkins, D.C.
-
Edward Charles Voss, D.C.
-
Douglas David Berry Jr., D.C.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist |
225700000X | MA00004428 | WA | Yes |
Addresses
Primary practice location
10107 213TH St E
Graham, WA 98338-8059
Mailing address
PO Box 988
Graham, WA 98338-0988
Phone (253) 847-2687
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 66473 | Other | WA | L&I NUMBER |
| 7694CL | Other | WA | REGENCE PROVIDER NUMBER |
Other providers in Graham, WA
- Shannon Carroll
- Terry Carver
- Yamilex Castro
- Susan Cha
- John T Chen
- Clear Vision Family PLLC
- Clear Vision Optometry, P.S.
- Community Health Care
- Community Health Care
- Matthew B Conant
All providers in Graham, WA · Massage Therapist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.