Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacey Clark, CDPT

Individual provider Counselor · NPI 1730676701

Jacey Clark, CDPT is a Counselor in Longview, Washington. Licensed in Washington. Registered with an NPI since 2018.

Licensed in
WA
In the registry since
2018
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Practice location Address checks out

720 14th Ave
Longview, WA 98632
Phone: (360) 353-9840
Fax: (360) 353-9880
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Counselor (primary) Taxonomy 101Y00000X · Licence 60823909 (WA)

Record details

NPI number1730676701
Entity typeIndividual (Type 1)
GenderMale
Credentials CDPT
Sole proprietorNo
NPI enumeratedApril 16, 2018
Last updated in NPPESMay 1, 2019
Mailing address921 14th Avenue, Longview, WA 98632

Other providers in Longview