Provider Demographics
NPI:1700866084
Name:MCNALLY, CYNTHIA G (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:G
Last Name:MCNALLY
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 1:2806 NE 105TH CIR
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98686-4031
Mailing Address - Country:US
Mailing Address - Phone:360-601-7285
Mailing Address - Fax:
Practice Address - Street 1:1306 MAIN ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-2919
Practice Address - Country:US
Practice Address - Phone:360-314-2384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-20
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00041848207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8426777Medicaid
WAGAB38269Medicare PIN
WA8426777Medicaid