Provider Demographics
NPI:1619915550
Name:MCLAY, CELIA W (DO)
Entity Type:Individual
Prefix:
First Name:CELIA
Middle Name:W
Last Name:MCLAY
Suffix:
Gender:F
Credentials:DO
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 1648
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97440-1648
Mailing Address - Country:US
Mailing Address - Phone:541-687-4900
Mailing Address - Fax:541-463-2820
Practice Address - Street 1:1007 HARLOW RD STE 310
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-7127
Practice Address - Country:US
Practice Address - Phone:541-463-2280
Practice Address - Fax:541-242-4227
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2595208100000X
ORDO210520204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810022380Medicaid
MEMM751902Medicare PIN
WV3810022380Medicaid