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Deactivated NPI 1427647494 Deactivated / Inactive NPI Male Practitioner

Mark Lewis Clark

Peer Specialist • Vancouver, WA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Mark Clark has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 14, 2021
NPI Deactivation Date June 19, 2024
Total Practice Duration ~3 Years of Practice (2021 – 2024)

Professional Overview & Biography Verified Profile Summary

Mark Clark was a registered Peer Specialist practicing in Vancouver, WA. Throughout an active medical career spanning 3 years, Mark Clark provided care at the practice location at 1601 E 4TH PLAIN BLVD until profile deactivation on 2024-06-19.

Practice Location & Contact Primary Location

Practice Address

1601 E 4th Plain Blvd

Vancouver, WA 986613713

Telephone 3603978246
Associated Practice Facility / Clinic
🏢 Portland Vamc Facility NPI 1255424685

Specialty Benchmarks & Practice Insights

Comparative analytics for Peer Specialist in Vancouver, WA

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

Practicing in Vancouver, WA (2660 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

Peer Specialist Primary Specialty

NUCC Taxonomy Code: 175T00000X

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Practice Associates & Co-Workers

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

40 Associated Practitioners
NPI 1003043332

Master of Social Work

Leticia Cuevas

Counselor - Addiction (Substance Use Disorder)

NPI 1003354259
Laura Tenney , SUDPT

Counselor - Addiction (Substance Use Disorder)

NPI 1003443482
Ena Valjevac

Counselor

NPI 1003458894
Jacob Hammond , CMHC

Counselor - Mental Health

NPI 1003654765
Marry-Kate Lindsey , SUDPT

Counselor - Addiction (Substance Use Disorder)

NPI 1003686171

Career & Practice History Timeline

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

7 Historical Events
⚠️
NPI Profile Deactivated June 19, 2024

Record deactivated on June 19, 2024

NPI Profile Active January 14, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location January 14, 2021

Registered at 1601 E 4TH PLAIN BLVD, VANCOUVER, WA 986613713 (Tel: 3603978246)

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Updated Business Mailing Address January 14, 2021

Registered at 1601 E 4TH PLAIN BLVD, VANCOUVER, WA 986613713 (Tel: 3603978246)

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Provider Name / Credentials Updated January 14, 2021

Recorded as MARK CLARK

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 14, 2021

Peer Specialist

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Initial NPI Registration & Enumeration January 14, 2021

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: 1427647494
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 14, 2021
Last Update: January 14, 2021
Deactivation Date: June 19, 2024

Mailing Address

1601 E 4th Plain Blvd

Vancouver, WA 986613713

Phone: 3603978246

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.