Josie Clark
Behavior Analyst in Tacoma, WA. Individual provider (NPI-1).
NPI number1063005668
StatusActive
Last updated in NPPESJul 25, 2025
Details
- NPI
- 1063005668
- Entity type
- Individual (NPI-1)
- Name
- Josie Clark
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 15, 2021
- Certification date
- Jul 25, 2025
- Last updated
- Jul 25, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103K00000X | Behavior Analyst | BA61618949 | WA | Yes |
| 106S00000X | Behavior Technician | – | – |
Practice location
3680 S Cedar St Ste ATacoma, WA 98409-5728
Phone 206-313-8840
Mailing address
Po Box 88083Tukwila, WA 98138-2083
Phone 206-313-8840
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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