Savannah Clark, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA61087633 Issued in WA

Practice address

11014 SE 192ND St
Renton, WA 98055-7432

Phone

(253) 852-8640

NPI assigned

Sep 14, 2021

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

State licenses

Practice roles

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.

• Marsh Chiropractic, PS

  • Massage Therapist
  • Renton, WA
  • NPI 1063570539
  NPD (past)
• Petrilli Chiropractic Services PS

  • Chiropractor
  • Renton, WA
  • NPI 1467678037

  Massage Therapist

  NPD (past)

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

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1821768631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 DUVALL AVE NE APT G723",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980595748",
            "telephone_number": "253-376-7193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11014 SE 192ND ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980557432",
            "telephone_number": "253-852-8640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SAVANNAH",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA61087633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Soaps",
            "affiliation": "N",
            "address_1": "11014 SE 192nd St",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980557432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Claire Kuo PLLC
• Clarity Wellness Center, LLC
• Clark Chiropractic Clinic
• Clark Chiropractic Inc
• Clark Chiropractic Inc
• Theodore Jeffrey Clark, D.C.
• Richard D Clarke, CRNA
• Classic Cabulance LLC
• Clearly Lasik, Inc.
• Margaret H Clements, MD

• Massage Therapist in Renton, WA
• Providers in Renton, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.