Dr Steven Clark and Associates, LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

2307-AT Issued in OR

Legal business name

DR STEVEN CLARK AND ASSOCIATES, LLC

Practice address

697 NW Division St
Gresham, OR 97030-5424

Phone

(503) 618-1119

Fax

(503) 661-1298

NPI assigned

Jan 15, 2016

Last updated

Mar 11, 2016By 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. Steven Clark, O.D.

Title

Optometrist

Phone

(503) 618-1119

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1452816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457654400000",
    "number": "1932566320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "697 NW DIVISION ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305424",
            "telephone_number": "503-618-1119",
            "fax_number": "503-661-1298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "697 NW DIVISION ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305424",
            "telephone_number": "503-618-1119",
            "fax_number": "503-661-1298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR STEVEN CLARK AND ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-15",
        "last_updated": "2016-03-11",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "503-618-1119",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "OR",
            "license": "2307-AT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Gresham, OR
• Providers in Gresham, OR by specialty
• Medical Specialty Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; 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.