Provider Demographics
NPI:1720062995
Name:MCCLAY, MARY F (MSN, CNS, ARNP)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:F
Last Name:MCCLAY
Suffix:
Gender:F
Credentials:MSN, CNS, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6715 NE 63RD ST
Mailing Address - Street 2:SUITE 103 BOX 140
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-1980
Mailing Address - Country:US
Mailing Address - Phone:360-904-6015
Mailing Address - Fax:
Practice Address - Street 1:11117 NE 189TH ST
Practice Address - Street 2:
Practice Address - City:BATTLE GROUND
Practice Address - State:WA
Practice Address - Zip Code:98604-6112
Practice Address - Country:US
Practice Address - Phone:360-904-6015
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006088363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health