JACQUELINE CLARK (NPI# 1497015762) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497015762 |
| Entity Type | Individual |
| Full Name | JACQUELINE CLARK |
| Practice Address |
923 Powell Ave Sw Suite 100 Renton WA 98057-2941 |
| Mailing Address |
325 W Gowe St Kent WA 98032-5892 |
| Practice Telephone | 2538337444 |
| Practice Fax Number | 4252266153 |
| Mailing Telephone | 2538337444 |
| Mailing Fax Number | 2535201799 |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2012-05-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
LH60275892 | WA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720594955 | Jacqueline Clark | Behavior Technician | 10530 Warwick Ave Ste C2, Fairfax, VA 22030-3132 | 2017-12-26 |
| 1336552629 | Jacqueline Clark | Specialist/Technologist | 550 Huntington Ave, Boston, MA 02115-5901 | 2014-06-04 |
| 1407008287 | Jacqueline Ruth Clark | Licensed Practical Nurse | 26308 Crocker Rd, Columbia Station, OH 44028-9301 | 2008-10-13 |
| 1902424161 | Jacqueline E Clark | Advanced Practice Midwife | 1021 Nebraska St, Sioux City, IA 51105-1436 | 2020-07-13 |
| 1205456795 | Jacqueline Clark | Behavior Technician | 182 El Dorado St, Monterey, CA 93940-3118 | 2020-04-24 |
| 1982175493 | Jacqueline Clark | Occupational Therapist | 888 Terrace St, Muskegon, MI 49440-1220 | 2018-12-10 |
| 1194244749 | Jacqueline Ann Clark | Counselor | 811 Madison St, Everett, WA 98203-4543 | 2017-09-14 |
| 1215452958 | Jacqueline Clark | Physical Therapist | 546 E Sandy Lake Rd Ste 110, Coppell, TX 75019-5787 | 2017-08-03 |
| 1245578343 | Jacqueline Anne Clark | Counselor | 2845 Bell St, Zanesville, OH 43701-1720 | 2013-01-24 |
| 1013255611 | Jacqueline Marie Clark | Registered Nurse | 700 19th St S, Birmingham, AL 35233-1927 | 2013-01-17 |
| Street Address |
923 POWELL AVE SW SUITE 100 |
| City | RENTON |
| State | WA |
| Zip Code | 98057-2941 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699134650 | Dynamic Rx Labs LLC | Pharmacy | 923 Powell Ave Sw, Suite 150, Renton, WA 98057-2941 | 2016-02-18 |
| 1902232663 | Robyn Dunning | Social Worker | 923 Powell Ave Sw, #100, Renton, WA 98057-2941 | 2013-09-25 |
| 1356685986 | Danelle Cartun | Counselor | 923 Powell Ave Sw, Renton, WA 98057-2941 | 2012-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043856628 | Megan Ramaiya | Student in an Organized Health Care Education/Training Program | King Count Sexual Assault & Resource Center, 200 Mill Ave S # 10, Renton, WA 98057 | 2019-11-19 |
| 1063076255 | Breanne Michele Smiley | Specialist/Technologist | 737 Logan Ave N, Renton, WA 98057 | 2019-04-24 |
| 1093215063 | Laura Lewis | Physical Medicine & Rehabilitation | 1000 Oakesdale Ave Sw Ste 100, Renton, WA 98057 | 2018-02-16 |
| 1437676004 | Ralph William Papke Jr. | Counselor | Kaiser Permanente of Wa, 1200 Sw 27th St, Renton, WA 98057 | 2017-08-24 |
| 1487106456 | Serengeti Care Partners LLC | Community/Behavioral Health | 707 S- Grady Way, Suite 6008, Renton, WA 98057 | 2016-10-26 |
| 1548716152 | Phandinh Ngoc Nguyen | Naturopath | 330 Sw 43rd St,suite L, Renton, WA 98057 | 2016-09-01 |
| 1275905721 | Todd R Glass | Chiropractor | 1024 N 10th Pl #2306, Renton, WA 98057 | 2015-10-23 |
| 1134595341 | Have A Heart | Case Management | 151 Taylor Ave Nw, Renton, WA 98057 | 2015-08-12 |
| 1780087171 | Brianne N Lefferts | Physical Therapist | 300 Sw 7th Street, Renton, WA 98057 | 2014-09-30 |
| 1588089460 | Sound Association Western Washington LLC | Audiologist | 108 Factory Ave. N., Ste 2b, Renton, WA 98057 | 2014-02-28 |
| Find all providers in zip 98057 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831706456 | Therapeuo LLC | Counselor | 16503 Se 171st Pl, Renton, WA 98058-9589 | 2020-09-28 |
| 1033730254 | Sandra Martinez | Counselor | 17728 134th Ln Se, Renton, WA 98058-6818 | 2020-04-28 |
| 1174159495 | Anna Higgins | Counselor | 1200 Grant Ave S Apt X201, Renton, WA 98055-3099 | 2020-03-18 |
| 1881233328 | Hannah Mae Bergeron | Counselor | 15617 Se 173rd St, Renton, WA 98058-9121 | 2020-01-01 |
| 1609426030 | Robert Arthur Martin Jr. | Counselor | 15 S Grady Way Ste 241, Renton, WA 98057-3209 | 2019-09-17 |
| 1417509068 | Jamila Bates | Counselor | 360 Taylor Ave Nw Apt 311, Renton, WA 98057-5148 | 2019-07-14 |
| 1982261400 | Makaela M Hayward | Counselor | 1025 S 3rd St Ste B, Renton, WA 98057-2765 | 2019-05-20 |
| 1447721089 | Alice Coleman | Counselor | 15 S Grady Way Ste 246, Renton, WA 98057-3209 | 2018-12-07 |
| 1033636147 | Masako Mcbride | Counselor | 1200 Sw 27th St # D1e01, Renton, WA 98057-2603 | 2017-08-29 |
| 1437676004 | Ralph William Papke Jr. | Counselor | Kaiser Permanente of Wa, 1200 Sw 27th St, Renton, WA 98057 | 2017-08-24 |
| Find all providers in RENTON | ||||
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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.