MR. GEORGE WESLEY CLARK CRM NPI 1750927075

NPI Information

NPI: 1750927075
Provider Name: MR. GEORGE WESLEY CLARK, CRM
Classification: Peer Specialist - 175T00000X
Entity Type: Individual
Address:
3647 HIGHWAY 39
KLAMATH FALLS, OR
ZIP 97603
Phone: (541) 884-5244
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MR. George Wesley Clark, CRM is a peer specialist in Klamath Falls, OR. The provider is 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. MR. George Wesley Clark, CRM NPI is 1750927075. 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:

3647 HIGHWAY 39
KLAMATH FALLS, OR
ZIP 97603-612
Phone: (541) 884-5244

The enumeration date for this NPI number is 11/21/2019 and was last updated on 10/12/2020.

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	License State	Primary
1	247200000X	Technician, Other		No
2	374700000X	Technician	OREGON	No
3	175T00000X	Peer Specialist		No
4	175T00000X	Peer Specialist	OREGON	Yes

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: 5/5/2024

NPI Synchronization or Removal

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