Healthcare Provider Details

I. General information

NPI: 1619915550
Provider Name (Legal Business Name): CELIA W MCLAY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 11/14/2022
Certification Date: 11/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 HARLOW RD STE 310
SPRINGFIELD OR
97477-7127
US

IV. Provider business mailing address

PO BOX 1648
EUGENE OR
97440-1648
US

V. Phone/Fax

Practice location:
  • Phone: 541-463-2280
  • Fax: 541-242-4227
Mailing address:
  • Phone: 541-687-4900
  • Fax: 541-463-2820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number2595
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberDO210520
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: