MEDICARE: JONATHAN WILSON CLARK OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	342831	OR

General Provider Information

NPI Number	:	1679943328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN WILSON CLARK OTR/L

Provider Business Mailing Address
First Line	:	3510 8TH DR
Second Line	:
City	:	BAKER CITY
State	:	OR
Zip	:	97814-1516
Country	:	US
Telephone Number	:	801-413-4395
Fax Number	:

Provider Business Practice Location Address
First Line	:	3175 POCAHONTAS RD
Second Line	:
City	:	BAKER CITY
State	:	OR
Zip	:	97814-1434
Country	:	US
Telephone Number	:	541-523-4415
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2015
Last Update Date	:	10/06/2015

Similar Medicare Providers

1841253408 — BUD W ZUNINO ARNP
Practice Location Address:

3175 POCAHONTAS RD
BAKER CITY, OR
97814-1434

Practice Phone: 541-523-4415
Practice Fax: 541-523-2399

1992734743 — BAKER CLINIC, LLP
Practice Location Address:

3175 POCAHONTAS RD
BAKER CITY, OR
97814-1434

Practice Phone: 541-523-4415
Practice Fax: 541-523-2399

1699709253 — DR. JON ERIC PETTERSON M.D.
Practice Location Address:

3175 POCAHONTAS RD
BAKER CITY, OR
97814-1434

Practice Phone: 541-523-4415
Practice Fax: 541-523-2399

1376577940 — DR. ROBERT MENZIE MCKIM M.D.
Practice Location Address:

3175 POCAHONTAS RD
BAKER CITY, OR
97814-1434

Practice Phone: 541-523-4415
Practice Fax: 541-523-2399

1568101095 — MAISHA LASHAWN BEAUCHAMP
Practice Location Address:

1434 MAIN ST STE A
BAKER, LA
70714-2838

Practice Phone: 225-522-0502
Practice Fax:

1093718330 — DR. PAMELA J. LOCKE O.D.
Practice Location Address:

410 N HYATT ST
TIPP CITY, OH
45371-1434

Practice Phone: 937-294-6435
Practice Fax:

Directions to “ JONATHAN WILSON CLARK OTR/L” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.