Basic Information
Provider Information
NPI: 1871970152
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCGUIRE
FirstName: CHELSEA
MiddleName: M
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 6149
Address2:  
City: ALOHA
State: OR
PostalCode: 970070149
CountryCode: US
TelephoneNumber: 5033528642
FaxNumber: 5033528658
Practice Location
Address1: 1151 N ADAIR ST
Address2:  
City: CORNELIUS
State: OR
PostalCode: 971138900
CountryCode: US
TelephoneNumber: 5033595564
FaxNumber: 5033574371
Other Information
ProviderEnumerationDate: 05/06/2015
LastUpdateDate: 03/03/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/31/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X274142MAN Allopathic & Osteopathic PhysiciansFamily Medicine 
207Q00000XMD195907ORY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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