Provider Demographics
NPI:1770140857
Name:CLARKE, JOSHUA DAVID (PT)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:DAVID
Last Name:CLARKE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 12TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-4920
Mailing Address - Country:US
Mailing Address - Phone:253-841-3422
Mailing Address - Fax:
Practice Address - Street 1:920 12TH AVE SE
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-4920
Practice Address - Country:US
Practice Address - Phone:253-841-3422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-23
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist