Provider Demographics
NPI:1588833495
Name:MCLACHLAN, GARY G (LMP)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:G
Last Name:MCLACHLAN
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13712 NE 20TH AVE
Mailing Address - Street 2:STE A
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98686-2702
Mailing Address - Country:US
Mailing Address - Phone:360-574-5944
Mailing Address - Fax:360-574-6430
Practice Address - Street 1:13712 NE 20TH AVE
Practice Address - Street 2:STE A
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98686-2702
Practice Address - Country:US
Practice Address - Phone:360-574-5944
Practice Address - Fax:360-574-6430
Is Sole Proprietor?:No
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00018102225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist