MARK W CLARK PSY.D. NPI 1114081577

NPI Information

  • NPI: 1114081577
  • Provider Name: MARK W CLARK, PSY.D.
  • Classification: Psychologist - 103TF0200X
  • Specialization: Forensic
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 7507 NE 51ST ST
    VANCOUVER, WA
    ZIP 98662
  • Phone: (360) 906-1190

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NPI Details

Mark W Clark, PSY.D. is a forensic psychologist in Vancouver, WA with 30 years of experience. The provider is a psychologist whose specialty is characterized by activities primarily intended to provide professional psychological expertise within the judicial and legal systems. Mark W Clark, PSY.D. NPI is 1114081577. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

7507 NE 51ST ST
VANCOUVER, WA
ZIP 98662-007
Phone: (360) 906-1190
Fax: (360) 906-1193

The NPI 1114081577 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 12/20/2006 and was last updated on 9/11/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TC0700XPsychologistClinicalPY2226WASHINGTONNo
2103TF0200XPsychologistForensicPY2226WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1164936MEDICAIDOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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