Provider Demographics
NPI:1992500714
Name:MCLAURY, DERRON (DC)
Entity type:Individual
Prefix:DR
First Name:DERRON
Middle Name:
Last Name:MCLAURY
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 SE 130TH CT
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-6034
Mailing Address - Country:US
Mailing Address - Phone:734-347-1976
Mailing Address - Fax:
Practice Address - Street 1:14511 NE 10TH AVE STE F
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-1386
Practice Address - Country:US
Practice Address - Phone:253-352-4280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH61406459111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation