DR. STACEY K CLARK (NPI# 1013170869) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013170869 |
| Entity Type | Individual |
| Full Name | DR. STACEY K CLARK |
| Credential | M.D. |
| Practice Address |
16528 E Desmet Ct Spokane Valley WA 99216-3522 |
| Mailing Address |
Po Box 421 Liberty Lake WA 99019-0421 |
| Practice Telephone | 5099448910 |
| Practice Fax Number | 5092277070 |
| Mailing Telephone | 5097472455 |
| Mailing Fax Number | 5092277070 |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2018-01-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | MD60733583 | WA | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 4301092664 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134686124 | Stacey Deann Clark | Licensed Vocational Nurse | 1400 Barron Ln, Axtell, TX 76624-1394 | 2019-02-26 |
| 1235624602 | Stacey Lynn Clark | Registered Nurse | 9709 Lincoln Hwy, Bedford, PA 15522 | 2018-06-27 |
| 1881192581 | Stacey Clark | Speech-Language Pathologist | 6301 Gaston Ave Ste 750, Dallas, TX 75214-3922 | 2018-01-28 |
| 1144607797 | Stacey Clark | Social Worker | 9040 Jackson Ave, Tacoma, WA 98431-1332 | 2015-05-04 |
| 1184808511 | Stacey Leigh Clark | Otolaryngology | 3705 Medical Pkwy, Suite 200, Austin, TX 78705-1019 | 2007-12-20 |
| 1699891580 | Stacey Ann Clark | Chiropractor | 11 Hill St, Lyndonville, VT 05851-8911 | 2007-03-22 |
| 1457481897 | Stacey Leigh Clark | Pharmacist | 303 Green St E, Wilson, NC 27893-4105 | 2007-03-06 |
| 1306905484 | Stacey L Clark | Counselor | 493 Westfield Rd, B, Noblesville, IN 46060-1327 | 2006-12-06 |
| 1528098712 | Stacey Ellen Clark | Nurse Practitioner | 414 E Main St, Durham, NC 27701-3720 | 2006-07-03 |
| 1285606574 | Stacey Ann Clark | Pediatrics | 1447 Medical Park Blvd, #402, Wellington, FL 33414 | 2006-02-02 |
| Street Address |
16528 E DESMET CT |
| City | SPOKANE VALLEY |
| State | WA |
| Zip Code | 99216-3522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992702914 | Philip D Woolf | Family Medicine | 16528 E Desmet Ct, Spokane Valley, WA 99216-3522 | 2005-07-05 |
| 1518504711 | Maggie Mary Bulger | Nurse Practitioner | 16528 E Desmet Ct, Spokane Valley, WA 99216-3522 | 2019-12-06 |
| 1083197768 | Karina Valhalla Caprez | Physician Assistant | 16528 E Desmet Ct, Spokane Valley, WA 99216-3522 | 2018-09-10 |
| 1831681683 | Aubrey Jean Bot | Registered Nurse | 16528 E Desmet Ct, Spokane Valley, WA 99216 | 2018-06-06 |
| 1639549439 | Josh Lute | Physician Assistant | 16528 E Desmet Ct, Spokane Valley, WA 99216-3522 | 2015-10-06 |
| 1720472996 | Yvette Greycen Dahl Rosser | Pediatrics | 16528 E Desmet Ct, Spokane Valley, WA 99216-3522 | 2015-03-25 |
| 1285063644 | Katie Marie Kasunick | Nurse Practitioner | 16528 E Desmet Ct, Spokane Valley, WA 99216-3522 | 2013-11-06 |
| 1649518259 | Jennifer Leigh Leigh Bowe | Registered Nurse | 16528 E Desmet Ct, Spokane Valley, WA 99216 | 2013-01-17 |
| 1659630549 | Steve Serrao | Internal Medicine | 16528 E Desmet Ct, Spokane Valley, WA 99216 | 2012-05-11 |
| 1114210812 | Carolyn Marjorie Campa | Nurse Practitioner | 16528 E Desmet Ct, Spokane Valley, WA 99216-3522 | 2011-05-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053920124 | Aark Laboratory | Clinical Medical Laboratory | 12709 E Mirabeau Pkwy Bldg A Ste 500, Spokane, WA 99216 | 2020-07-24 |
| 1922622158 | Vera Whole Health Wa, PC | Clinic/Center | 16009 E Indiana Ave, Spokane Valley, WA 99216 | 2020-06-03 |
| 1023654001 | Rebecca Elizabeth Ryan | Massage Therapist | 12505 E 23rd Ave, Spokane Valley, WA 99216 | 2019-11-25 |
| 1356992903 | Creative Communication LLC | Speech-Language Pathologist | 13607 E. Sprague Ave, Spokane Valley, WA 99216 | 2019-09-25 |
| 1972096584 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 15319 E Indiana Ave Ste 2, Spokane Valley, WA 99216 | 2018-06-08 |
| 1356845655 | Rp Operations, LLC | Assisted Living Facility | 13013 E Mission Ave, Spokane Valley, WA 99216 | 2018-03-21 |
| 1174036305 | Talk, Learn and Communicate | Speech-Language Pathologist | 13607 East Spraque Avenue, Spokane Valley, WA 99216 | 2017-11-09 |
| 1134638281 | Vtc Vitality Healthcare | Pain Medicine | 12409 E Mission Ave Ste 102, Spokane Valley, WA 99216 | 2017-09-20 |
| 1285150086 | Robert C Tsay Jr. | Pharmacist | 12415 E 12th Ave, Apt 110, Spokane Valley, WA 99216 | 2017-08-15 |
| 1629505607 | Spokane Valley Medical, Inc | Durable Medical Equipment & Medical Supplies | 12509 E. Mission Ave, Suite #103, Spokane, WA 99216 | 2017-05-22 |
| Find all providers in zip 99216 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447664529 | Kaleb Lorenz Topp | Emergency Medicine | 12606 E Mission Ave, Spokane Valley, WA 99216-3421 | 2014-06-17 |
| 1912169806 | Jade Reed Bringhurst | Emergency Medicine | 12606 E Mission Ave, Spokane Valley, WA 99216-3421 | 2008-07-01 |
| 1356533988 | James Hunter Mafera | Emergency Medicine | 12606 E Mission Ave, Spokane Valley, WA 99216-3421 | 2007-08-17 |
| 1538205794 | Randall Volk | Emergency Medicine | 16528 E Desmet Ct, Spokane Valley, WA 99216-3522 | 2007-01-29 |
| 1376602052 | Paula M Silha | Emergency Medicine | 12606 E Mission Ave, Spokane Valley, WA 99216-3421 | 2006-12-08 |
| 1740349414 | Merry M Alto | Emergency Medicine | 12606 E Mission Ave, Spokane Valley, WA 99216-3421 | 2006-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659985554 | Trans-west Ambulance Service LLC | Emergency Medicine | 526 N West Ave # Pmb112, Arlington, WA 98223-1251 | 2020-09-08 |
| 1629602016 | Franciscan Medical Group | Emergency Medicine | 3556 Market Pl W Ste 109, University Place, WA 98466-4339 | 2020-02-25 |
| 1477010676 | Hcmd LLC | Emergency Medicine | 11477 Nw Admiral Pl, Silverdale, WA 98383-4503 | 2019-02-23 |
| 1801352505 | Western Washington Emergency Physicians Pllc | Emergency Medicine | 14815 Pacific Ave S, Parkland, WA 98444-4654 | 2019-02-18 |
| 1013490507 | Dispatchhealth Washington PC | Emergency Medicine | 6912 220th St Sw Ste 113, Mountlake Terrace, WA 98043-2174 | 2018-09-11 |
| 1659802320 | Anders Conway | Emergency Medicine | 413 Lilly Rd Ne Dept Of, Olympia, WA 98506-5133 | 2017-03-24 |
| 1457705147 | Daniel Hinds | Emergency Medicine | 10019 N Austin Ln, Spokane, WA 99208-6072 | 2016-04-19 |
| 1497140206 | Angus Agnew | Emergency Medicine | 315 M.l.k. Jr. Way, Tacoma, WA 98405 | 2015-03-30 |
| 1518376151 | Karthikeyan Muthuswamy | Emergency Medicine | St Clare Hospital Emergency Department, 11315 Bridgeport Way Sw, Lakewood, WA 98499 | 2014-08-07 |
| 1285041137 | Anthony Guynes | Emergency Medicine | Swedish Phys. Redmond, 18100 Ne Union Hill Rd. Ste 200, Redmond, WA 98052-3330 | 2014-07-11 |
| Find all providers with the same taxonomy | ||||
| City | SPOKANE VALLEY |
| Zip Code | 99216 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.