Lara Clark, in Tacoma, WA - Medicare Nurse Practitioner

Lara Clark, is a medicare enrolled "Nurse Practitioner - Pediatrics" in Tacoma, Washington. Her current practice location is 1112 S Cushman Ave, Tacoma, Washington. You can reach out to her office (for appointments etc.) via phone at (253) 593-2144.

Lara Clark is licensed to practice in Washington (license number AP60376142) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1447684832.

Contact Information

	Lara Clark,
	1112 S Cushman Ave, Tacoma, WA 98405-3631
	(253) 593-2144
	(253) 272-4125

Map and Direction

Provider's Profile

Full Name	Lara Clark
Gender	Female
Speciality	Nurse Practitioner - Pediatrics
Location	1112 S Cushman Ave, Tacoma, Washington
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1447684832
Provider Enumeration Date: 08/21/2013
Last Update Date: 08/21/2013

Medicare PECOS Information:

PECOS PAC ID: 2163666553
Enrollment ID: I20130925000746

Medical Identifiers

Medical identifiers for Lara Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1447684832	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0200X	Nurse Practitioner - Pediatrics	AP60376142 (Washington)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Lara Clark allows following entities to bill medicare on her behalf.

Entity Name	The Association Of Chrmc And University Physicians
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1255449963 PECOS PAC ID: 9133032964 Enrollment ID: O20031107000585

Entity Name	Seattle Children's Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1003319500 PECOS PAC ID: 9032021050 Enrollment ID: O20031211000532

Entity Name	Sea-mar Community Health Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1811051170 PECOS PAC ID: 7315831161 Enrollment ID: O20040211001210

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lara Clark is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Lara Clark, Po Box 34703, Seattle, WA 98124-1703 Ph: (206) 764-3335	Lara Clark, 1112 S Cushman Ave, Tacoma, WA 98405-3631 Ph: (253) 593-2144

Reviews and Comments

Nurse Practitioner Nurses in Tacoma, WA

Salome Odja Dockendorf, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1201 Pacific Ave Ste 19501201, Tacoma, WA 98402 Phone: 812-870-6728
Barbara L Kapuscinski, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 9040 Jackson Ave, Tacoma, WA 98431 Phone: 253-968-2751
Ms. Christine J. Larsen, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3580 Pacific Ave, Tacoma, WA 98418 Phone: 253-798-4500 Fax: 253-798-4493
Rick Hahn, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 315 Martin Luther King Jr Way, Tacoma, WA 98405 Phone: 253-403-1000
Mrs. Kimberley Anne Burns, APRN,BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1617 S J St, Tacoma, WA 98405 Phone: 253-274-7504
Randi Marie Berg, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 9040 Reid St, Tacoma, WA 98431 Phone: 253-968-2315
Marlene I Bridgforth, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1901 S Cedar St, #301 Cardiac Study Center Inc Ps, Tacoma, WA 98405 Phone: 253-572-7320 Fax: 253-627-3191

Lara Clark, - Medicare Nurse Practitioner in Tacoma, WA