Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | MD154898 | OR |
Y | 207RC0000X | Internist - Cardiovascular Disease | MD60569960 | WA |
NPI | 1023211018 |
---|---|
Provider Name | Joel David Mclarry |
First Address | Portland, OR 97211-3667 |
Second Address | Vancouver, WA 98664-1913 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2007 |
Last Update Date | 04/02/2022 |