Provider Demographics
NPI:1912739012
Name:MCQUADE, LAUREN NICOLE (CHW)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:NICOLE
Last Name:MCQUADE
Suffix:
Gender:F
Credentials:CHW
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:NICOLE
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:694 CHURCH ST NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-2401
Mailing Address - Country:US
Mailing Address - Phone:503-588-5827
Mailing Address - Fax:503-315-0714
Practice Address - Street 1:694 CHURCH ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-2401
Practice Address - Country:US
Practice Address - Phone:503-588-5827
Practice Address - Fax:503-315-0714
Is Sole Proprietor?:No
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR111954172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker