Katie Jane Clark

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

44 Industrial Way Ste D
Lebanon, OR 97355-4364

Phone

(541) 801-4113

NPI assigned

Oct 3, 2019

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Interoperability endpoints

• Direct secure messaging: katie.clark2@dhsoha.state.or

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

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1780225474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 HILL ST SE",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973226711",
            "telephone_number": "541-801-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 INDUSTRIAL WAY STE D",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973554364",
            "telephone_number": "541-801-4113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44 Industrial Way Ste D",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "OR",
            "postal_code": "973554364",
            "country_code": "US",
            "telephone_number": "541-259-5880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KATIE",
        "middle_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-03",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Katie.Clark2@dhsoha.state.or",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "eMAIL",
            "address_1": "44 Industrial Way Ste D",
            "city": "Lebanon",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973554364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeremy Chu
• Alexa Rae Churan
• Kristen L Claflin, RN
• Ariene R Clark, O.D.
• Dennis Willard Clark, D.D.S.
• Emi Claydon, L.M.T.
• Ronald A Clifton, DC
• Stefanie R Coffey, DNP
• Alice B Cole, MS, QMHP
• Ronald James Combe, D.C.

• Specialist in Lebanon, OR
• Providers in Lebanon, OR by specialty
• Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; 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.