Provider Demographics
NPI:1790850105
Name:MCNAUGHTON, LAUREN (MD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:MCNAUGHTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2685 4TH ST NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-6548
Mailing Address - Country:US
Mailing Address - Phone:503-540-0288
Mailing Address - Fax:503-540-0293
Practice Address - Street 1:2685 4TH ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-6548
Practice Address - Country:US
Practice Address - Phone:503-540-0288
Practice Address - Fax:503-540-0293
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD15161208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR163857Medicaid
OR163857Medicaid