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

Jerry Dean Clark, SUDR, CPC, AAC

Individual provider Peer Specialist · NPI 1497232060

Jerry Dean Clark, SUDR, CPC, AAC is a Peer Specialist in Centralia, Washington. Licensed in Washington. Registered with an NPI since 2018.

Licensed in
WA
In the registry since
2018
Specialties on file
3
What do these letters mean?
CPC — Certified Professional Coder
A medical coding credential, not a clinical one.

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Practice location Address checks out

1616 S Gold St Ste 4
Centralia, WA 98531-8930
Phone: (360) 807-4929
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence CP61099597 (WA)
Peer Specialist Taxonomy 175T00000X · Licence CG60783169 (WA)
Peer Specialist Taxonomy 175T00000X (WA)

Record details

NPI number1497232060
Entity typeIndividual (Type 1)
GenderMale
Credentials SUDR , CPC , AAC
Sole proprietorNo
NPI enumeratedJuly 25, 2018
Last updated in NPPESNovember 13, 2020
Certification dateNovember 13, 2020

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