Active NPI
Clinton James Foriska, DO
- Family Medicine Physician
- Tacoma, WA
National Provider Identifier
1982277703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- OP61573453
- Practice address
- 521 Martin Luther King Jr Way
Tacoma, WA 98405-4238 - Phone
- (253) 792-6680
- Fax
- (253) 403-2915
- NPI assigned
- Jul 20, 2021
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | WA | ||
| Family Medicine Physician | 207Q00000X | OP61573453 | WA | Primary |
Addresses
Primary practice location
521 Martin Luther King Jr Way
Tacoma, WA 98405-4238
Mailing address
101 Rainbow Way Unit B
Kelso, WA 98626-2046
Other practice location 1
200 University Pkwy
Yakima, WA 98901-9539
Phone (509) 452-5100
Other practice location 2
914 S Scheuber Rd
Centralia, WA 98531-9027
Phone (360) 736-2803
Other practice location 3
1718 E Kessler Blvd
Longview, WA 98632-1842
Phone (360) 747-5800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1718 Kessler Blvd
Longview, WA 98632-3634
Phone (360) 747-5800
Hospital & facility affiliations
- Assured Home Health and Hospice
- Peacehealth Southwest Home Health
- Peacehealth St John Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peacehealth | Family Medicine | Current | Accepting new patients |
| Peacehealth | Past | Accepting new patients |
Locations
1615 Delaware St
Longview, WA 98632
Phone (360) 363-4818
1718 E Kessler Blvd
Longview, WA 98632
Phone (360) 747-5800
Interoperability endpoints
- cforiska760268@direct.peacehealth.org
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Longview, WA
- NPI 1275501538
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Centralia, WA
- NPI 1154397305
-
- General Acute Care Hospital
- Longview, WA
- NPI 1073510277
-
- Home Health Agency
- Vancouver, WA
- NPI 1285720896
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747267200000",
"number": "1982277703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 RAINBOW WAY UNIT B",
"city": "KELSO",
"state": "WA",
"postal_code": "986262046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "521 MARTIN LUTHER KING JR WAY",
"city": "TACOMA",
"state": "WA",
"postal_code": "984054238",
"telephone_number": "253-792-6680",
"fax_number": "253-403-2915"
}
],
"practiceLocations": [
{
"address_1": "200 University Pkwy",
"address_purpose": "LOCATION",
"city": "Yakima",
"state": "WA",
"postal_code": "989019539",
"country_code": "US",
"telephone_number": "509-452-5100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "914 S Scheuber Rd",
"address_purpose": "LOCATION",
"city": "Centralia",
"state": "WA",
"postal_code": "985319027",
"country_code": "US",
"telephone_number": "360-736-2803",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1718 E Kessler Blvd",
"address_purpose": "LOCATION",
"city": "Longview",
"state": "WA",
"postal_code": "986321842",
"country_code": "US",
"telephone_number": "360-747-5800",
"fax_number": "360-575-3846",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FORISKA",
"first_name": "CLINTON",
"middle_name": "JAMES",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-07-20",
"last_updated": "2025-05-15",
"certification_date": "2025-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "WA",
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "OP61573453",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.