Provider Demographics
NPI:1770538415
Name:MCLAUGHLIN, WENDY P (PAC)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:P
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1625 N GEORGE MASON DR
Mailing Address - Street 2:STE 375
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3683
Mailing Address - Country:US
Mailing Address - Phone:703-717-4170
Mailing Address - Fax:703-717-4171
Practice Address - Street 1:1625 N GEORGE MASON DR
Practice Address - Street 2:STE 375
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3683
Practice Address - Country:US
Practice Address - Phone:703-717-4170
Practice Address - Fax:703-717-4171
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0110001393363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA54-0981048OtherTIN
VAC88858Medicare PIN
VA54-0981048OtherTIN