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

Mr. Kevin John Clark, LCPO

Individual provider Orthotist · NPI 1790115004

Mr. Kevin John Clark, LCPO is an Orthotist in Seattle, Washington. Licensed in Washington. Registered with an NPI since 2013.

Licensed in
WA
In the registry since
2013
Specialties on file
2
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Practice location Address checks out

411 12th Ave Ste 200
Seattle, WA 98122-5599
Phone: (206) 328-4276
Fax: (206) 328-1037
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthotist (primary) Taxonomy 222Z00000X · Licence 01 60414623 (WA)
Prosthetist Taxonomy 224P00000X · Licence PS 60414610 (WA)

Record details

NPI number1790115004
Entity typeIndividual (Type 1)
GenderMale
Credentials LCPO
Sole proprietorNo
NPI enumeratedNovember 22, 2013
Last updated in NPPESNovember 22, 2013

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