MEDICARE: DANIELLE MCCLURE

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	103K00000X	Behavior Analyst	LBA.BA.70125229	WA

General Provider Information

NPI Number	:	1588062368
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE MCCLURE

Provider Business Mailing Address
First Line	:	231 SE BARRINGTON DR STE 203
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-3200
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	231 SE BARRINGTON DR STE 203
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-3200
Country	:	US
Telephone Number	:	360-240-0022
Fax Number	:

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

Provider Enumeration Date	:	12/10/2014
Last Update Date	:	05/07/2026

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