Provider Demographics
NPI:1891051058
Name:MCLAUGHLIN, NOELLE CHRISTINE
Entity Type:Individual
Prefix:MRS
First Name:NOELLE
Middle Name:CHRISTINE
Last Name:MCLAUGHLIN
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 1:320SEBAKER ST
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-6038
Mailing Address - Country:US
Mailing Address - Phone:503-474-3600
Mailing Address - Fax:503-474-3601
Practice Address - Street 1:320 SE BAKER ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128
Practice Address - Country:US
Practice Address - Phone:503-474-3600
Practice Address - Fax:503-474-3601
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-02
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200741427RN390200000X
OR201405805NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500680851Medicaid