| Thomas Bennett Clark Jr, CRNA | |
|
1959 Ne Pacific St, Seattle, WA 98195-0001 | |
| (206) 520-5000 | |
| Not Available |
| Full Name | Thomas Bennett Clark Jr |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 19 Years |
| Location | 1959 Ne Pacific St, Seattle, Washington |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245301894 | NPI | - | NPPES |
| 2010101 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | AP60093669 (Washington) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Washington Gastroenterology Pllc | 6204194848 | 118 |
| Entity Name | Franciscan Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093165334 PECOS PAC ID: 0547173866 Enrollment ID: O20031111000789 |
| Entity Name | Yakima Valley Memorial Physicians |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306933940 PECOS PAC ID: 1557391596 Enrollment ID: O20050818000714 |
| Entity Name | Washington Gastroenterology Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306364401 PECOS PAC ID: 6204194848 Enrollment ID: O20180103000884 |
| Entity Name | Gastroenterology Associates Clinical Practice Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811556442 PECOS PAC ID: 2062770605 Enrollment ID: O20191025001578 |
| Entity Name | Narrows Surgery Center Ps |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1093449225 PECOS PAC ID: 4880060888 Enrollment ID: O20231023001783 |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas Bennett Clark Jr, CRNA Po Box 50095, Seattle, WA 98145-5095 Ph: () - | Thomas Bennett Clark Jr, CRNA 1959 Ne Pacific St, Seattle, WA 98195-0001 Ph: (206) 520-5000 |
Timothy D Butterworth, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 325 9th Ave, Seattle, WA 98104 Phone: 206-520-5000 | |
Mrs. Sara Beth Maples, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1959 Ne Pacific St, Box 356540, Seattle, WA 98195 Phone: 206-598-4260 | |
Simran Kennedy, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 325 9th Ave, Box 359724, Seattle, WA 98104 Phone: 206-744-8491 Fax: 206-744-8009 | |
Michael Mielniczek, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1959 Ne Pacific St, Seattle, WA 98195 Phone: 206-520-5000 | |
Justin R. Howard, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1959 Ne Pacific St, Seattle, WA 98195 Phone: 206-520-5000 | |
Peyton G. Lane, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 325 9th Ave, Seattle, WA 98104 Phone: 206-520-5000 | |
Vanessa Fernandez, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1100 9th Ave, Seattle, WA 98101 Phone: 206-624-1144 |