DR. DANICA E CLARK (NPI# 1972792992) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972792992 |
| Entity Type | Individual |
| Full Name | DR. DANICA E CLARK |
| Credential | MD |
| Practice Address |
12360 E Burnside St Portland OR 97233-1042 |
| Mailing Address |
1776 Sw Madison St Portland OR 97205-1715 |
| Practice Telephone | 9712794800 |
| Practice Fax Number | 9712792051 |
| Mailing Telephone | 5032241044 |
| Mailing Fax Number | 5032244494 |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2020-11-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | MD154535 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500644845 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 15 N Morris St, Portland, OR 972271541 | 5032309875 | 5032309877 |
| 17645 Nw Saint Helens Rd, Portland, OR 972311729 | 5036211069 | 5036210200 |
| 300 N Graham St # 230, Portland, OR 972271683 | 5034134340 | |
| Msc10 5550, 1 University of New Mexico, Albuquerque, NM 871310001 | 5052724661 | 5052724628 |
| Street Address |
12360 E BURNSIDE ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97233-1042 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508856188 | Artice E Geary | Social Worker | 12360 E Burnside St, Portland, OR 97233-1042 | 2005-10-25 |
| 1487262937 | Erica P Woody | Counselor | 12360 E Burnside St, Portland, OR 97233-1042 | 2020-07-21 |
| 1609416155 | Cara A Koch | Counselor | 12360 E Burnside St, Portland, OR 97233-1042 | 2020-01-13 |
| 1245878552 | Janelle M Bombara | Dietitian, Registered | 12360 E Burnside St, Portland, OR 97233-1042 | 2019-12-17 |
| 1932756707 | Holly A Fay | Registered Nurse | 12360 E Burnside St, Portland, OR 97233-1042 | 2019-08-26 |
| 1013570548 | Christa R Andreasen | Registered Nurse | 12360 E Burnside St, Portland, OR 97233-1042 | 2019-04-19 |
| 1679046965 | Emerson N Begay | Pharmacy Technician | 12360 E Burnside St, Portland, OR 97233-1042 | 2019-01-09 |
| 1215429394 | Phillip C Lacy | Pharmacy Technician | 12360 E Burnside St, Portland, OR 97233-1042 | 2018-06-04 |
| 1992205223 | Sarah E Bruno | Social Worker | 12360 E Burnside St, Portland, OR 97233-1042 | 2018-02-13 |
| 1093233868 | Sarah S Rivera | Peer Specialist | 12360 E Burnside St, Portland, OR 97233-1042 | 2017-08-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205448164 | Moore Therapy Services, LLC | Behavioral Analyst | 2053 Se 181st Ave, Portland, OR 97233 | 2020-08-20 |
| 1427563733 | Central City Concern Inc | Clinic/Center | 1415 Se 122nd Ave, Portland, OR 97233 | 2017-12-08 |
| 1427573443 | Sunshine Ahc | In Home Supportive Care | 2217 Se 156th Ave, Portland, OR 97233 | 2017-08-10 |
| 1538609433 | Nathaniel Davis Jr. | Counselor | 8915 Se Center St, Tigard, OR 97233 | 2017-02-27 |
| 1154878627 | Oregon Outreach Inc | Case Management | 1740 South East 139th Avenue, Portland, OR 97233 | 2016-09-01 |
| 1023461019 | Julianne Baltzley | Counselor | 2409 Se 149th Avenue, Portland, OR 97233 | 2016-07-14 |
| 1710332143 | Emma Slater | Counselor | 12360 Se Burnside, Portland, OR 97233 | 2016-05-04 |
| 1245621952 | Gregory Brett Bledsoe | Counselor | 1427 Se 182nd Ave., Portland, OR 97233 | 2015-02-17 |
| 1396149852 | Jacqueline Bension | Counselor | 1705 Se 122nd Ave, Portland, OR 97233 | 2014-10-13 |
| 1700206950 | Olga I Zlatova I | Dental Hygienist | 325 Se 154th Ave, Portland, OR 97233 | 2014-04-25 |
| Find all providers in zip 97233 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770107302 | Vpa PC | Internal Medicine | 1500 Ne 15th Ave Apt 431, Portland, OR 97232-4418 | 2020-05-29 |
| 1073167730 | Oregon Adult Medicine PC | Internal Medicine | 2330 Nw Flanders St Ste 201, Portland, OR 97210-3460 | 2019-07-30 |
| 1265889265 | Jared Tobolski | Internal Medicine | 22 Bramhall St Dept Of, Portland, ME 04102-3175 | 2016-05-19 |
| 1528421039 | Celine Haotian Zhou | Internal Medicine | 3181 Sw Sam Jackson Park Rd, L-579, Ohsu, Portland, OR 97239 | 2016-04-01 |
| 1043685407 | Michael David Fox | Internal Medicine | 1015 Nw 22nd Ave # 230, Portland, OR 97210-3025 | 2015-12-09 |
| 1134516701 | Anne Longtine | Internal Medicine | 65 Waterville St, Portland, ME 04101 | 2015-04-22 |
| 1184016099 | Wendy W Yu | Internal Medicine | 9135 Sw Barnes Rd Ste 763, Portland, OR 97225-6777 | 2015-03-02 |
| 1639586191 | Stefan Christison | Internal Medicine | 1120 Nw 20th Ave Ste 110, Portland, OR 97209-1591 | 2014-07-16 |
| 1336551555 | Lee Michael Anthony | Internal Medicine | 9205 Sw Barnes Rd Mt-2800, Portland, OR 97225-6603 | 2014-05-22 |
| 1558772889 | Kyaw Zin Thein | Internal Medicine | 3485 S Bond Ave, Portland, OR 97239-4503 | 2014-05-08 |
| Find all providers in PORTLAND | ||||
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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.