| Doctor Name: | EMMA JEAN CLARK |
| NPI Number: | 1508917055 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMP |
| License Number: | MA00028464 |
| Business Practice Address: | 21907 64th Ave. W Suite # 110 Mountlake Terrace, WA - 98043 |
| Business Phone Number: | 4256735220 |
| Business Fax Number: | 4256731597 |
| Mailing Address: | 2445 140th Ave. Ne, Suite B-105 BELLEVUE |
| State: | WA |
| Postal Code: | 98005 |
| Phone Number: | 4256446328 |
| Fax Number: | 4256446295 |
| NPI Enumeration Date: | 01/12/2007 |
| NPI Last Update Date: | 04/28/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225700000X |
| License Number: | MA00028464 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Massage Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |