Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1861705964 Individual Practitioner Male Practitioner

Dr. Theodore Jeffrey Clark , DC

Chiropractor • Renton, WA

Professional Overview & Biography Verified Profile Summary

Dr. Theodore Clark, DC is a registered healthcare professional specializing in Chiropractor in Renton, WA. Practice services are available at 17422 108TH AVE SE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

17422 108th Ave Se
#101

Renton, WA 980555400

Telephone 4252550427
Fax 4252551066
Associated Practice Facility / Clinic
🏢 Clark Chiropractic Inc Facility NPI 1700904778

Specialty Benchmarks & Practice Insights

Comparative analytics for Chiropractor in Renton, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 27.8 Yrs
State Avg: 23.7 Yrs
Regional Practice Density
44 Specialists

Practicing in Renton, WA (3154 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

Chiropractor Primary Specialty

NUCC Taxonomy Code: 111N00000X

State License WA 2219

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
Ellie Ferkingstad , LMT

Massage Therapist

NPI 1003637224

Licensed Massage Therapist

Shawn Griffin , LMT

Massage Therapist

NPI 1063179737

Licensed Massage Therapist

Lance Bunning , LMT

Physical Medicine & Rehabilitation

NPI 1639616931

Licensed Massage Therapist

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active July 17, 2010

NPI status registered as active in NPPES database

📍
Updated Practice Location July 17, 2010

Registered at 17422 108TH AVE SE, #101, RENTON, WA 980555400 (Tel: 4252550427)

📍
Updated Business Mailing Address July 17, 2010

Registered at 17422 108TH AVE SE, 101, RENTON, WA 980555400 (Tel: 4252550427)

👤
Provider Name / Credentials Updated July 17, 2010

Recorded as THEODORE CLARK, D.C.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 17, 2010

Chiropractor (License #2219 in WA)

🟢
Initial NPI Registration & Enumeration July 17, 2010

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: 1861705964
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 17, 2010
Last Update: July 17, 2010
Sole Proprietor: Yes

Mailing Address

17422 108th Ave Se, 101

Renton, WA 980555400

Phone: 4252550427

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.