Active NPI
Eric Christopher Clark, CRNA
- Certified Registered Nurse Anesthetist
- Seattle, WA
National Provider Identifier
1982963070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RN9268891
- Practice address
- 4800 Sand Point Way NE
Seattle, WA 98105-3901 - Phone
- (206) 987-2000
- NPI assigned
- May 9, 2012
- Last updated
- Aug 30, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN9268891 | FL | Primary |
Addresses
Primary practice location
4800 Sand Point Way NE
Seattle, WA 98105-3901
Mailing address
3300 NE 65TH St Unit 221
Seattle, WA 98115-7368
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 006380700 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN9268891 | FL | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Association of Chrmc and University Physicians | Current | Accepting new patients | |
| Association of CHMC and University Physicians | Current | Accepting new patients |
Locations
900 Pacific Ave
Ste 100
Everett, WA 98201
Phone (425) 304-6080
4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
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-
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- Richland, WA
- NPI 1851680664
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661817600000",
"number": "1982963070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 NE 65TH ST UNIT 221",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981157368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 SAND POINT WAY NE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981053901",
"telephone_number": "206-987-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "ERIC",
"middle_name": "CHRISTOPHER",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-09",
"last_updated": "2022-08-30",
"certification_date": "2022-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "FL",
"license": "RN9268891",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "006380700",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.