Clark, Kevin John
Clark, Kevin John is an individual health care provider with primary practice located at 411 12Th Ave Suite 200, Seattle WA 98122-5599. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist is his primary health care specialty. Clark, Kevin John can be contacted via phone (206) 328-4276.Contact Information
Primary practice address
411 12Th Ave Suite 200
Seattle WA 98122-5599
Phone: (206) 328-4276
Fax: (206) 328-1037
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist | 222Z00000X | 01 60414623 | Washington |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist | 224P00000X | PS 60414610 | Washington |
Profile Details
NPI number | 1790115004 |
---|---|
LBN Legal business name | Clark, Kevin John |
Credentials | LCPO |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Nov 22nd, 2013 |
Last updated | Nov 22nd, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1790115004 | NPPES |
Washington | MEDICAID | 9015561 |
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