MR. THOMAS BENNETT CLARK JR. (NPI# 1245301894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245301894 |
| Entity Type | Individual |
| Full Name | MR. THOMAS BENNETT CLARK JR. |
| Credential | CRNA |
| Practice Address |
209 Lilly Rd Ne Olympia WA 98506 |
| Practice Telephone | 3604138250 |
| Practice Fax Number | 3604138830 |
| Mailing Telephone | 3604138250 |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2020-10-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | AP60093669 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 367500000X | Nurse Anesthetist, Certified Registered | 1086511 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669096020 | Thomas Edward Clark | Optometrist | 3672 W South Jordan Pkwy Ste 103, South Jordan, UT 84009-7172 | 2020-06-02 |
| 1861053811 | Thomas J Clark | Massage Therapist | 16615 North Rd Unit B, Bothell, WA 98012-5983 | 2019-06-20 |
| 1922417005 | Thomas Boyle Clark IIi | Pathology | 3619 Pacific Ave, Tacoma, WA 98418-7921 | 2014-08-04 |
| 1053558205 | Thomas Edward Clark | Student in an Organized Health Care Education/Training Program | 980 Western Avenue, Albany, NY 12202 | 2009-01-09 |
| 1255593273 | Thomas James Clark | Licensed Practical Nurse | 8703 Shear Dr, Powell, OH 43065-8835 | 2008-06-30 |
| 1508044181 | Thomas B Clark | Chiropractor | 2092 Casa De Vereda, Vista, CA 92084-4223 | 2008-02-05 |
| 1306061502 | Thomas Lyon Clark | Psychologist | 1515 Payne St, Tallahassee, FL 32303-5796 | 2007-04-16 |
| 1487877213 | Thomas R Clark | Chiropractor | 2418 W 9th Ave, Amarillo, TX 79106-6620 | 2007-04-10 |
| 1023157153 | Thomas Clark | Dentist | 4402 Airline Dr, Houston, TX 77022-2934 | 2007-02-05 |
| 1972649499 | Thomas Colin Clark | Physical Therapist | 7111 E 21st St N Ste 103, Wichita, KS 67206 | 2007-01-30 |
| Street Address |
209 LILLY RD NE |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912515685 | Taija Marie Leonard | Nurse Practitioner | 209 Lilly Rd Ne, Olympia, WA 98506 | 2020-07-20 |
| 1902264856 | Stephanie Mitchell | Nurse Practitioner | 209 Lilly Rd Ne, Olympia, WA 98506 | 2016-02-07 |
| 1164544953 | Nicholas Keith Weber | Internal Medicine | 209 Lilly Rd Ne, Olympia, WA 98506 | 2007-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477185460 | Chloe Harper | Technician, Other | 3443 Lilly Rd Se, Ste B, Olympia, WA 98506 | 2020-02-07 |
| 1912543539 | Jessica Marie Radakovich | Licensed Practical Nurse | 3426 Mary Elder Rd, Olympia, WA 98506 | 2019-11-19 |
| 1669014973 | Arlene Josephine Adams | Registered Nurse | 413 Lily Rd Ne, Olympia, WA 98506 | 2019-10-09 |
| 1861999120 | Debra Delores Barker | Licensed Practical Nurse | 3710 South Bay Rd Ne, Olympia, WA 98506 | 2018-04-12 |
| 1801304431 | Michelle Warner | Nurse Practitioner | 205 Lilly Rd Ne Ste A1, Olympia, WA 98506 | 2018-01-17 |
| 1396258364 | Institute for Family Development | Community/Behavioral Health | 204 Quince St. Ne, Suite 200, Olympia, WA 98506 | 2017-11-13 |
| 1083137715 | Cameron Kunkel | Specialist/Technologist | 2512 20th Ave Ne, Olympia, WA 98506 | 2017-07-25 |
| 1184144768 | Trevor Shane Kwan | Family Medicine | 525 Lilly Road Ne, Olympia, WA 98506 | 2017-06-23 |
| 1073043212 | Michael H Harburg | Behavior Technician | 3857 Martin Way Ne, Olympia, WA 98506 | 2017-06-19 |
| 1780114371 | Priscilla Kangyang Jadu | Counselor | 3857 Martin Way E., Olympia, WA 98506 | 2017-06-15 |
| Find all providers in zip 98506 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538528682 | Capital Anesthesia, LLC | Nurse Anesthetist, Certified Registered | 4220 20th Ln Nw, Olympia, WA 98502-8522 | 2016-02-17 |
| 1417250796 | Donna Margaret Funk | Nurse Anesthetist, Certified Registered | 3425 Ensign Rd. Ne Suite 310, South Sound Oral Surgery Ensign Medical Center, Olympia, WA 98506 | 2010-12-08 |
| 1972780294 | Kaori Donohue | Nurse Anesthetist, Certified Registered | 3920 Capital Mall Dr Sw Ste 300, Olympia, WA 98502-8701 | 2008-01-29 |
| 1790337558 | Katharine Conley | Nurse Anesthetist, Certified Registered | 3900 Capital Mall Dr Sw, Olympia, WA 98502-8654 | 2019-07-11 |
| 1700397163 | Manuel P Hernandez | Nurse Anesthetist, Certified Registered | 500 Lilly Rd Ne Ste 150, Olympia, WA 98506 | 2017-10-12 |
| 1144673682 | Daniel Hanson | Nurse Anesthetist, Certified Registered | 3900 Capital Mall Dr Sw, Olympia, WA 98502-8654 | 2016-07-20 |
| 1144571175 | Erik C Engen | Nurse Anesthetist, Certified Registered | 3900 Capital Mall Drive Sw, Olympia, WA 98502-8654 | 2012-10-01 |
| 1831476977 | Eli Staker | Nurse Anesthetist, Certified Registered | 3900 Capitol Mall Dr Sw, Olympia, WA 98502-8654 | 2011-11-03 |
| 1265764567 | Elizabeth K Couture | Nurse Anesthetist, Certified Registered | 3900 Capitol Mall Dr Sw, Olympia, WA 98502-8654 | 2010-02-11 |
| 1386883775 | Sheridan Healthcare of Washington, PC | Nurse Anesthetist, Certified Registered | 3900 Capital Mall Drive Sw, Olympia, WA 98502-8654 | 2009-02-10 |
| Find all providers in OLYMPIA | ||||
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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.