Basic Information
| Provider Information | |||||||||
| NPI: | 1134275977 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MACCLAIN | ||||||||
| FirstName: | ALMA | ||||||||
| MiddleName: | REGINA | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 130 RAILROAD AVE | ||||||||
| Address2: | PO BOX 44 | ||||||||
| City: | REARDAN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 99029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092584517 | ||||||||
| FaxNumber: | 5092584456 | ||||||||
| Practice Location | |||||||||
| Address1: | 6203 AGENCY LOOP ROAD | ||||||||
| Address2: | |||||||||
| City: | WELLPINIT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 99040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092584517 | ||||||||
| FaxNumber: | 5092584456 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP2201X | RN00034154 | WA | Y | Nursing Service Providers | Registered Nurse | Ambulatory Care |
No ID Information.