MEDICARE: SAMANTHA MCCLAIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant		OR

General Provider Information

NPI Number	:	1366393472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA MCCLAIN

Provider Business Mailing Address
First Line	:	17895 SW HIGGINS ST APT 311
Second Line	:
City	:	BEAVERTON
State	:	OR
Zip	:	97007-8875
Country	:	US
Telephone Number	:	971-716-3096
Fax Number	:

Provider Business Practice Location Address
First Line	:	17895 SW HIGGINS ST APT 311
Second Line	:
City	:	BEAVERTON
State	:	OR
Zip	:	97007-8875
Country	:	US
Telephone Number	:	971-716-3096
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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