Jacqulyn Maxine McDougal, LMT

Primary specialty

MechanotherapistTaxonomy code 172M00000X

License

1582 Issued in OR

Practice address

8755 SW Christine Dr
Suite 102
Wilsonville, OR 97070

Phone

(503) 682-1110

Fax

(503) 682-1118

NPI assigned

Dec 15, 2008

Last updated

Dec 15, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1229299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229299200000",
    "number": "1093950354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7149 SW SAGERT ST",
            "address_2": "SUITE 103",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628261",
            "telephone_number": "503-706-3833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8755 SW CHRISTINE DR",
            "address_2": "SUITE 102",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "97070",
            "telephone_number": "503-682-1110",
            "fax_number": "503-682-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDOUGAL",
        "first_name": "JACQULYN",
        "middle_name": "MAXINE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-15",
        "last_updated": "2008-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "OR",
            "license": "1582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann McCarthy
• John McCarthy
• Zachary Austin Xavier McClintock
• Cameron McCombs, DPT
• Ryan McCormic, D.C.
• Misty McDowell, N.D.
• Amy McDuffee, ND
• McGeehans Nutritional Consultation, Inc (Inner View)
• Katherine Mary McKinley, OTR/L
• Ian Andrew McLean, DPT

• Mechanotherapist in Wilsonville, OR
• Providers in Wilsonville, OR by specialty
• Mechanotherapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.