KENDRA RAE CLARK (OTR/L) – Occupational Therapist, NPI 1225723430

KENDRA RAE CLARK (OTR/L) is a healthcare provider. based in Spokane, Washington. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials OTR/L. They hold a License No. OT61398414 (WA). The NPI Number for KENDRA RAE CLARK (OTR/L) is 1225723430

Main info

Female
Accepts Medicare Assignment
Name
KENDRA RAE CLARK (OTR/L)
NPI
1225723430
Phone
(509) 209-7429
Address
1515 S TECHNOLOGY RD
Enumeration Date
5 April 2023
Last Update Date
7 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8667466696
Graduation Year
null (2026 years ago)
PAC ID
8527572098
Group Practice PAC ID
0345512596
Professional Enrollment ID
I20250708000908
Address ID
WA992160834SP222XXRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness85
Years active:3State licenses:1Digital endpointsOther names

460 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in WA

Provider Addresses for KENDRA RAE CLARK (OTR/L)

  • 1515 S TECHNOLOGY RD

    SPOKANE, WA 992245003

    Phone: (509) 209-7429

    Fax: (509) 340-9942

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-07-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250708000908IOccupational Therapist In Private PracticeWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 99224)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0345512596View full group profile
NameSpecialtyState
Occupational Therapist In Private PracticeWA
-WA
Qualified Speech Language PathologistWA
Occupational Therapist In Private PracticeMT
Occupational Therapist In Private PracticeMT
-WA
Physical Therapist In Private PracticeMT
Physical Therapist In Private PracticeWA
-ID
Qualified Speech Language PathologistMT

Reviews

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Frequently asked questions

How do I look up KENDRA RAE CLARK (OTR/L) by NPI?
Use NPI 1225723430 when you need to reference KENDRA RAE CLARK (OTR/L) in forms, claims, or directories.
Does this profile mean KENDRA RAE CLARK (OTR/L) is currently active?
Yes — KENDRA RAE CLARK (OTR/L) appears active in the national provider directory.
What kind of provider is KENDRA RAE CLARK (OTR/L)?
The page reflects Occupational Therapist for KENDRA RAE CLARK (OTR/L). Clinical services aligned with this taxonomy classification.
Where is KENDRA RAE CLARK (OTR/L)'s primary listing?
We display Spokane, Washington because that is what the record indicates for KENDRA RAE CLARK (OTR/L).
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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