Active NPI
Patricia Kayte Clark, HA 61144575
- Hearing Instrument Specialist
- Colville, WA
National Provider Identifier
1942956602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 61144575
- Practice address
- 710 S Main St
Colville, WA 99114-2508 - Phone
- (509) 684-2120
- Fax
- (509) 684-3260
- NPI assigned
- Feb 22, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Assistive Technology Supplier Audiologist | 231HA2500X | 61144575 | WA | |
| Hearing Instrument Specialist | 237700000X | 61144575 | WA | Primary |
Addresses
Primary practice location
710 S Main St
Colville, WA 99114-2508
Mailing address
710 S Main St
Colville, WA 99114-2508
Phone (509) 684-2120
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 |
|---|---|---|---|
| 61144575 | WA | MD | Assistive Technology Supplier Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1645488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653350400000",
"number": "1942956602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 S MAIN ST",
"city": "COLVILLE",
"state": "WA",
"postal_code": "991142508",
"telephone_number": "509-684-2120",
"fax_number": "509-684-3260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 S MAIN ST",
"city": "COLVILLE",
"state": "WA",
"postal_code": "991142508",
"telephone_number": "509-684-2120",
"fax_number": "509-684-3260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "PATRICIA",
"middle_name": "KAYTE",
"credential": "HA 61144575",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-22",
"last_updated": "2022-05-24",
"certification_date": "2022-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "231HA2500X",
"taxonomy_group": "",
"desc": "Audiologist, Assistive Technology Supplier",
"state": "WA",
"license": "61144575",
"primary": false
},
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "WA",
"license": "61144575",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.