NPIMap

Organization Active NPI

Clark Chiropractic Inc

  • Massage Therapist
  • Renton, WA
National Provider Identifier
1962078279
Registry record updated May 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Legal business name
CLARK CHIROPRACTIC INC
Practice address
17422 108TH Ave SE #101
Renton, WA 98055-5400
Phone
(425) 255-0427
Fax
(425) 255-1066
NPI assigned
May 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2021

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

Authorized official

Name
Mrs. Jennifer K Neathery, LMT
Title
Massage Therapist
Phone
(425) 255-0427

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X Primary

Addresses

Primary practice location

17422 108TH Ave SE #101
Renton, WA 98055-5400

Mailing address

17422 108TH Ave SE #101
Renton, WA 98055-5400
Phone (425) 255-0427

National Provider Directory

National Provider Directory
Tax ID family
Clark Chiropractic Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1622160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622160000000",
    "number": "1962078279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17422 108TH AVE SE #101",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555400",
            "telephone_number": "425-255-0427",
            "fax_number": "425-255-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17422 108TH AVE SE #101",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555400",
            "telephone_number": "425-255-0427",
            "fax_number": "425-255-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-28",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A",
        "authorized_official_last_name": "NEATHERY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MASSAGE THERAPIST",
        "authorized_official_telephone_number": "425-255-0427",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; 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.