Provider Demographics
NPI:1023382298
Name:MCAULEY, LAURA R (MA)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:R
Last Name:MCAULEY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 SW 27TH CIR
Mailing Address - Street 2:
Mailing Address - City:TROUTDALE
Mailing Address - State:OR
Mailing Address - Zip Code:97060-1833
Mailing Address - Country:US
Mailing Address - Phone:503-438-5767
Mailing Address - Fax:
Practice Address - Street 1:927 SW 27TH CIR
Practice Address - Street 2:
Practice Address - City:TROUTDALE
Practice Address - State:OR
Practice Address - Zip Code:97060-1833
Practice Address - Country:US
Practice Address - Phone:503-438-5767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-05
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide