Provider Demographics
NPI:1992376974
Name:MCLAUGHLIN, VANESSA MARILYN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:MARILYN
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:VANESSA
Other - Middle Name:MARILYN
Other - Last Name:AMABILE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:955 POWELL AVE SW
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2908
Mailing Address - Country:US
Mailing Address - Phone:425-277-1311
Mailing Address - Fax:425-277-1566
Practice Address - Street 1:8301 161ST AVE NE STE 103
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3858
Practice Address - Country:US
Practice Address - Phone:425-882-1697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA363A00000X
WAPA61181354363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant