Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1790115004 Individual Practitioner Male Practitioner

Kevin John Clark , LCPO

Orthotist • Seattle, WA

Professional Overview & Biography Verified Profile Summary

Kevin Clark, LCPO is a registered healthcare professional specializing in Orthotist in Seattle, WA. Practice services are available at 411 12TH AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

411 12th Ave
Suite 200

Seattle, WA 981225599

Telephone 2063284276
Fax 2063281037
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Orthotist in Seattle, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
22 Specialists

Practicing in Seattle, WA (84 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

Orthotist Primary Specialty

NUCC Taxonomy Code: 222Z00000X

State License WA 01 60414623

A health care professional who is specifically educated and trained to manage comprehensive orthotic patient care, including musculoskeletal and neuromuscular anomalies resulting from injuries or disease processes involving the lower extremity, upper extremity or spinal segment/s and positional deformation of the cranium. Orthotists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care.

Prosthetist

NUCC Taxonomy Code: 224P00000X

State License WA PS 60414610

A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
9015561 (WA)

Practice Associates & Co-Workers

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

10 Associated Practitioners
Gregory Ferguson , CP

Specialist - Prosthetics Case Management

NPI 1003108804
NPI 1144654237
NPI 1174239354

Certified Orthotist, LO

Julie Schaar , ORTHOTIST

Specialist - Prosthetics Case Management

NPI 1255667143
NPI 1376084608

CP, Licensed Psychologist

Douglas Pinkley , LPO, CPO

Specialist - Prosthetics Case Management

NPI 1497978365

LPO, Certified Prosthetist Orthotist

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active November 22, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location November 22, 2013

Registered at 411 12TH AVE, SUITE 200, SEATTLE, WA 981225599 (Tel: 2063284276)

📍
Updated Business Mailing Address November 22, 2013

Registered at 411 12TH AVE, SUITE 200, SEATTLE, WA 981225599 (Tel: 2063284276)

👤
Provider Name / Credentials Updated November 22, 2013

Recorded as KEVIN CLARK, LCPO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 22, 2013

Orthotist (License #01 60414623 in WA)

🟢
Initial NPI Registration & Enumeration November 22, 2013

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: 1790115004
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 22, 2013
Last Update: November 22, 2013
Sole Proprietor: No

Mailing Address

411 12th Ave, Suite 200

Seattle, WA 981225599

Phone: 2063284276

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.