MRS. KIM J. CLARK (NPI# 1609069087) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609069087 |
| Entity Type | Individual |
| Full Name | MRS. KIM J. CLARK |
| Credential | LMP |
| Practice Address |
1424 16th Ave Longview WA 98632-2901 |
| Practice Telephone | 3604256620 |
| Practice Fax Number | 3604251277 |
| Mailing Telephone | 3604256620 |
| Mailing Fax Number | 3604251277 |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2007-08-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MA00018876 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760638290 | Kim Michele Clark | Registered Nurse | 6820 Nw Grandview Dr, Corvallis, OR 97330-2706 | 2008-08-15 |
| 1700934072 | Kim M. Clark | Massage Therapist | 9508 Canyon Rd E, Puyallup, WA 98371-6302 | 2007-01-05 |
| 1215091095 | Kim M Clark | Optometrist | 12000 Se 82nd Avenue, #2012, Portland, OR 97266-7721 | 2006-12-19 |
| 1497236301 | Kim Clark | Counselor | 1800 Mercy Dr, Orlando, FL 32808-5646 | 2018-08-28 |
| 1225428402 | Kim Clark | Behavioral Analyst | 510 W. 11th Street, Family Solutions, Medford, OR 97501 | 2015-01-27 |
| 1023255940 | Kim Evans Clark | Nurse Anesthetist, Certified Registered | 701 Grove Rd, 2nd Floor Anesthesia, Greenville, SC 29605-5611 | 2009-01-14 |
| 1316135312 | Kim Ann Clark | Case Manager/Care Coordinator | 829 Halbert St, Malvern, AR 72104-2607 | 2007-10-04 |
| 1508074311 | Kim Clark | Social Worker | 226 Leonard Rd, South Royalton, VT 05068-9565 | 2007-05-18 |
| Street Address |
1424 16TH AVE |
| City | LONGVIEW |
| State | WA |
| Zip Code | 98632-2901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396786125 | Darin J. Shook | Chiropractor | 1424 16th Ave, Longview, WA 98632-2901 | 2006-06-10 |
| 1841635984 | Elysia J.b. Harrsch | Naturopath | 1424 16th Ave, Longview, WA 98632-2901 | 2013-05-02 |
| 1134564230 | Katana Beth King | Naturopath | 1424 16th Ave, Longview, WA 98632-2901 | 2013-05-02 |
| 1265625628 | Diane Michelle Miollis | Massage Therapist | 1424 16th Ave, Longview, WA 98632-2901 | 2007-08-20 |
| 1750497236 | Advantage Chiropratic & Massage, P.s. | Chiropractor | 1424 16th Ave, Longview, WA 98632-2901 | 2006-08-21 |
| 1326084609 | Anik Julie St-martin | Chiropractor | 1424 16th Ave, Longview, WA 98632-2901 | 2006-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992366 | Honor Senior Care LLC | Home Health Aide | 1135 3rd Ave, Ste S101, Longview, WA 98632 | 2020-11-03 |
| 1417416728 | Sam Wise | Dentist | 1538 11th Ave Lowr Columbia, Longview, WA 98632 | 2019-03-16 |
| 1053870717 | Matthew Johnson | Physician Assistant | 900 Ocean Beach Hwy Ste 110, Longview, WA 98632 | 2019-03-12 |
| 1295205367 | Abid Valji | Occupational Therapist | Americana Health and Rehabilitation Center, 917 7th Ave, Longview, WA 98632 | 2018-11-30 |
| 1184106437 | Peacehealth | Durable Medical Equipment & Medical Supplies | Triangle Mall Suite 16 1015 Ocean Beach Hwy, Longview, WA 98632 | 2018-09-04 |
| 1982186318 | Linda Joan Mason | Licensed Practical Nurse | 1153 23rd Ave, Longview, WA 98632 | 2018-09-01 |
| 1891291910 | Ellen Sumner Hornbeak | Physical Therapist | 200 Triangle Shopping Ctr Ste 270, Longview, WA 98632 | 2018-04-05 |
| 1700399961 | Johnna Joyce Knapp | Speech-Language Pathologist | 2615 Lilac St, Longview, WA 98632 | 2017-11-09 |
| 1841711868 | Deborah Annette Burzynski | Registered Nurse | 1057 12th Avenue, Longview, WA 98632 | 2017-06-29 |
| 1598291122 | Cheyenne West | Counselor | 1616 10th Avenue, Longview, WA 98632 | 2017-05-02 |
| Find all providers in zip 98632 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710520002 | Raevyn N Reichle | Massage Therapist | 208 N Fredonia St, Longview, TX 75601-7209 | 2019-10-19 |
| 1023581063 | Krista Pohl | Massage Therapist | 1324 Vandercook Way, Longview, WA 98632-3902 | 2019-01-02 |
| 1326514126 | Margaret Jan Duszik | Massage Therapist | 915 W Loop 281 Ste 107-12, Longview, TX 75604-2935 | 2018-10-18 |
| 1639618655 | Codreaming LLC | Massage Therapist | 414 E Loop 281 Ste 20, Longview, TX 75605-7931 | 2017-02-23 |
| 1962828392 | Charles Seamus Crane | Massage Therapist | 1157 3rd Ave Ste 145, Longview, WA 98632-6004 | 2014-03-10 |
| 1730500745 | Shawn Shumway | Massage Therapist | 803 Vandercook Way Ste 12, Longview, WA 98632-4039 | 2013-12-17 |
| 1396007886 | Stephanie N Scott | Massage Therapist | 513 Ruthlynn Dr, Longview, TX 75605-3725 | 2012-06-12 |
| 1346529278 | John Howard Helaire | Massage Therapist | 804 Coleman Dr, Longview, TX 75605-3106 | 2011-08-09 |
| 1881980035 | Laurie Ann Lake | Massage Therapist | 1600 Springdale St, Longview, TX 75604-2635 | 2011-06-27 |
| 1952602914 | Jennifer R Wilson | Massage Therapist | 3394 N Us Highway 259, Longview, TX 75605-5086 | 2010-11-08 |
| Find all providers in LONGVIEW | ||||
Please comment or provide details below to improve the information on MRS. KIM J. CLARK.
| 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.