Provider Demographics
NPI:1396138152
Name:MCLAUGHLIN, RYAN ELIZABETH (LAC)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:ELIZABETH
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3351 N HALLECK ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-7234
Mailing Address - Country:US
Mailing Address - Phone:484-767-8617
Mailing Address - Fax:
Practice Address - Street 1:39420 SE GORDON CREEK RD
Practice Address - Street 2:
Practice Address - City:CORBETT
Practice Address - State:OR
Practice Address - Zip Code:97019-8750
Practice Address - Country:US
Practice Address - Phone:503-695-2977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC170836171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist