Provider Demographics
NPI:1154483279
Name:MCLAIN, ELIZABETH ROBYN (LMP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ROBYN
Last Name:MCLAIN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:MISS
Other - First Name:ELIZABETH
Other - Middle Name:ROBYN
Other - Last Name:BRAME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:717 NE 61ST ST
Mailing Address - Street 2:#202
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-8753
Mailing Address - Country:US
Mailing Address - Phone:360-905-0101
Mailing Address - Fax:360-735-7330
Practice Address - Street 1:205 E 11TH ST
Practice Address - Street 2:STE LL1
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-3200
Practice Address - Country:US
Practice Address - Phone:360-905-0101
Practice Address - Fax:360-735-7330
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00021289225700000X
OR11103225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist