- Practice location
- 2188 SW Park Pl Ste 10, Portland, OR 97205-1100
- Phone
- 503-568-1390
- Fax
- —
- Last updated
- August 25, 2021
Carissa Ann Clark is a Massage Therapist based in Portland, OR. Carissa Ann Clark practices in Portland, OR and has the professional credentials of LMT. The NPI Number for Carissa Ann Clark is 1194492371. The current practice location address for Carissa Ann Clark is 2188 SW Park Pl Ste 10, Portland, OR 97205-1100 and can be reached out via phone at 503-568-1390.
Provider Profile Details
- NPI Number
- 1194492371
- Provider Name
- Carissa Ann Clark
- Credential
- LMT
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 2188 SW Park Pl Ste 10, Portland, OR 97205-1100
- Phone Number
- 503-568-1390
- Primary Taxonomy
- Massage Therapist · 225700000X
- Sole Proprietor
- No
- Other Names
- Carissa Ann Jobe (Former Name)
- Provider Enumeration Date
- August 25, 2021
- Last Update Date
- August 25, 2021
- Certification Date
- August 25, 2021
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 2188 SW Park Pl Ste 10
Portland, OR 97205-1100 - City
- Portland
- State
- Oregon
- Zip
- 97205-1100
- Phone Number
- 503-568-1390
Provider Business Mailing Address Details
- Address
- 2188 SW Park Pl Ste 10
Portland, OR 97205-1100 - City
- Portland
- State
- OR
- Zip
- 97205-1100
- Phone Number
- 503-568-1390
License Information
- License State
- OR
- Taxonomy
- Massage Therapist · 225700000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Carissa A Clark, LMT?
The NPI number of Carissa A Clark, LMT is 1194492371. It was assigned on August 25, 2021 and is currently active in the NPPES registry.
What is the specialty of Carissa A Clark, LMT?
Carissa A Clark, LMT is registered under the primary taxonomy Massage Therapist (code 225700000X).
Where does Carissa A Clark, LMT practice?
The practice location is 2188 SW Park Pl Ste 10, Portland, OR 97205-1100. The office can be reached at 503-568-1390 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1194492371 directly on the NPPES registry website.