Active NPI
Clayton Delaney Farmer, ATC, LMP
- Athletic Trainer
- Kirkland, WA
National Provider Identifier
1861645996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- A160047875
- Practice address
- 12609 NE 132ND St
Unit B
Kirkland, WA 98034-3139 - Phone
- (425) 516-9919
- NPI assigned
- Nov 3, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | A160047875 | WA | Primary |
| Massage Therapist | 225700000X | MA00011153 | WA |
Addresses
Primary practice location
12609 NE 132ND St
Unit B
Kirkland, WA 98034-3139
Mailing address
12609 NE 132ND St
Unit B
Kirkland, WA 98034-3139
Phone (425) 516-9919
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 |
|---|---|---|---|
| A160047875 | WA | MD | Athletic Trainer |
| MA00011153 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412640000000",
"number": "1861645996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12609 NE 132ND ST",
"address_2": "UNIT B",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980343139",
"telephone_number": "425-516-9919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12609 NE 132ND ST",
"address_2": "UNIT B",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980343139",
"telephone_number": "425-516-9919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARMER",
"first_name": "CLAYTON",
"middle_name": "DELANEY",
"credential": "ATC, LMP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-11-03",
"last_updated": "2014-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WA",
"license": "A160047875",
"primary": true
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA00011153",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirkland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.