Clark Therapeutic Massage
Massage Therapist in Graham, WA. Organization (NPI-2).
NPI number1770620064
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1770620064
- Entity type
- Organization (NPI-2)
- Legal business name
- Clark Therapeutic Massage
- Organization subpart
- No
- Enumeration date
- Jan 30, 2007
- Last updated
- Aug 22, 2020
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 |
|---|---|---|---|---|
| 225700000X | Massage Therapist | MA00004428 | WA | Yes |
Practice location
10107 213th St EGraham, WA 98338-8059
Phone 253-847-2687 · Fax 253-846-3012
Mailing address
Po Box 988Graham, WA 98338-0988
Phone 253-847-2687 · Fax 253-846-3012
Authorized official
Linda Patricia Clark
Owner
2538472687
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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All 46 Massage Therapist providers in Graham · All 326 providers in Graham
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