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General NPI Number Information
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NPI Number | 1851389118
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Entity Type | Individual
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Provider Name | LINDA ANN MCCLELLAN DO PHD
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Gender | Female
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Dates
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Enumeration Date | 10/11/2005
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Last Update Date | 06/27/2023
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Provider Practice Location Address
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Address Line | 8495 CRATER LAKE HWY
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City | WHITE CITY
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State | OR
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Zip | 97503-3011
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Country | US
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Telephone | 541-826-2111
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Fax |
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Provider Business Mailing Address
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Address Line | 8495 CRATER LAKE HWY
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City | WHITE CITY
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State | OR
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Zip | 97503
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Country | US
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Telephone | 541-826-2111
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Fax | 713-627-7302
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | M7487
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 531087
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 00116224
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License Number State | MO
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