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General NPI Number Information
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NPI Number | 1992500714
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Entity Type | Individual
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Provider Name | DERRON MCLAURY D.C.
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Gender | Male
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Dates
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Enumeration Date | 02/17/2025
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 14511 NE 10TH AVE STE F
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City | VANCOUVER
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State | WA
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Zip | 98685-1386
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Country | US
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Telephone | 253-352-4280
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Fax |
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Provider Business Mailing Address
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Address Line | 622 SE 130TH CT
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City | VANCOUVER
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State | WA
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Zip | 98683-6034
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Country | US
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Telephone | 734-347-1976
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Fax |
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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 | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | CH61406459
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License Number State | WA
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