Trevor J. Clark PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

TREVOR J. CLARK PLLC

Practice address

1437 NE Everett St
Camas, WA 98607-1366

Phone

(971) 285-5861

NPI assigned

Feb 23, 2023

Last updated

Feb 23, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Trevor Clark, DCNPI 1144644360

Title

Owner

Phone

(971) 285-5861

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 3

• Clark Bodyworks Other name
• East County Chiropractic Other name
• Trevor J. Clark Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Trevor Clark, D.C.

  • Chiropractor
  • Washougal, WA
  • NPI 1144644360
  NPD Authorized official

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

{
    "created_epoch": "1677110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677110400000",
    "number": "1912606427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 722",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986070722",
            "telephone_number": "971-285-5861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1437 NE EVERETT ST",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986071366",
            "telephone_number": "971-285-5861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3904 NE 242nd Ave",
            "address_purpose": "LOCATION",
            "city": "Camas",
            "state": "WA",
            "postal_code": "986077189",
            "country_code": "US",
            "telephone_number": "971-285-5861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TREVOR J. CLARK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-23",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "971-285-5861",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2042469",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clark Bodyworks",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "East County Chiropractic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Trevor J. Clark",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Chiropractor in Camas, WA
• Providers in Camas, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; 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.