Thomas J Clark, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60546680 Issued in WA

Practice address

16615 North Rd Unit B
Bothell, WA 98012-5983

Phone

(206) 498-4681

NPI assigned

Jun 20, 2019

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560988800000",
    "number": "1861053811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16615 NORTH RD UNIT B",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980125983",
            "telephone_number": "206-498-4681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16615 NORTH RD UNIT B",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980125983",
            "telephone_number": "206-498-4681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "THOMAS",
        "middle_name": "J",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-20",
        "last_updated": "2019-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60546680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "bothell",
            "affiliation": "N",
            "address_1": "16615 North Rd Unit B",
            "city": "Bothell",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980125983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christine Lentz DDS and Lisa Egbert DDS PS
• Julidang K Chue, DDS
• Leslie Cisneros
• City of Bothell
• James Daniel Clark, DNP, APRN, FNP-BC
• Roxanne Clemence, LMP, LMT
• Kathleen Patricia Clutter, M.A.
• Alice J Coad, ARNP
• Wendy Coard, MD
• Niecole Monisha Coder, DDS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.