Basic Information
Provider Information
NPI: 1144696915
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCCLORY
FirstName: CHRISTINA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2051 KAEN RD
Address2: SUITE 367
City: OREGON CITY
State: OR
PostalCode: 970454035
CountryCode: US
TelephoneNumber: 5037425300
FaxNumber: 5037425979
Practice Location
Address1: 37400 BELL ST
Address2:  
City: SANDY
State: OR
PostalCode: 970557868
CountryCode: US
TelephoneNumber: 5036683483
FaxNumber: 5036681892
Other Information
ProviderEnumerationDate: 08/17/2015
LastUpdateDate: 08/17/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X201141498ORY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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