Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1588158307 Individual Practitioner Female Practitioner

Stefanie Clark , LMT

Massage Therapist • Pullman, WA

Professional Overview & Biography Verified Profile Summary

Stefanie Clark, LMT is a registered healthcare professional specializing in Massage Therapist in Pullman, WA. Practice services are available at 1205 SE BISHOP BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1205 Se Bishop Blvd
Suite #109

Pullman, WA 99163

Telephone 5094263507

Specialty Benchmarks & Practice Insights

Comparative analytics for Massage Therapist in Pullman, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 23.0 Yrs
State Avg: 17.3 Yrs
Regional Practice Density
33 Specialists

Practicing in Pullman, WA (13385 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Massage Therapist Primary Specialty

NUCC Taxonomy Code: 225700000X

State License WA MA60852983

An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Wa State Department Of Health
MA60852983 (WA)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active June 15, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location June 15, 2018

Registered at 1205 SE BISHOP BLVD, SUITE #109, PULLMAN, WA 99163 (Tel: 5094263507)

📍
Updated Business Mailing Address June 15, 2018

Registered at 1205 SE BISHOP BLVD, SUITE #109, PULLMAN, WA 99163 (Tel: 5094263507)

👤
Provider Name / Credentials Updated June 15, 2018

Recorded as STEFANIE CLARK, LMT

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 15, 2018

Massage Therapist (License #MA60852983 in WA)

🟢
Initial NPI Registration & Enumeration June 15, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1588158307
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 15, 2018
Last Update: June 15, 2018
Sole Proprietor: Yes

Mailing Address

1205 Se Bishop Blvd, Suite #109

Pullman, WA 99163

Phone: 5094263507

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.