Provider Demographics
NPI:1578334298
Name:MCLAUCHLAN, AIRAVEE CHELANE
Entity Type:Individual
Prefix:
First Name:AIRAVEE
Middle Name:CHELANE
Last Name:MCLAUCHLAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 165
Mailing Address - Street 2:
Mailing Address - City:COSMOPOLIS
Mailing Address - State:WA
Mailing Address - Zip Code:98537-0165
Mailing Address - Country:US
Mailing Address - Phone:206-853-1591
Mailing Address - Fax:
Practice Address - Street 1:1812 SUMNER AVE
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-4602
Practice Address - Country:US
Practice Address - Phone:206-853-1591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health