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Individual

MR. LAWRANCE H MCCLUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LICSW

Contact information

Practice address
1601 E FOURTH PLAIN BLVD, VANCOUVER, WA 98661-3713
(360) 558-5728
Mailing address
1601 E FOURTH PLAIN BLVD, VANCOUVER, WA 98661-3713
(360) 558-5728

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
5199106-3501
UT
1041C0700X
Clinical Social Worker
Primary
LW61173433
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
107035228101
U006
UT
01
51991063500001
BLUE CROSS
UT
01
885125
U002
UT
01
942938348MCM
U003
UT
Enumeration date
12/05/2005
Last updated
08/11/2021
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