Healthcare Provider Details

I. General information

NPI: 1225456684
Provider Name (Legal Business Name): JILLIAN MEGAN MCLAUGHLIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2014
Last Update Date: 10/06/2024
Certification Date: 10/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3927 RUCKER AVE
EVERETT WA
98201-4833
US

IV. Provider business mailing address

3927 RUCKER AVE
EVERETT WA
98201-4833
US

V. Phone/Fax

Practice location:
  • Phone: 425-339-5470
  • Fax: 425-317-4649
Mailing address:
  • Phone: 425-339-5470
  • Fax: 425-317-4649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number61484813
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number61484813
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: