Active NPI
Mica Ngoc Lan Laclair, RN
- Registered Nurse
- Redmond, OR
National Provider Identifier
1235828880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 10002172
- Practice address
- 340 NW 5TH St Ste 204
Redmond, OR 97756-1869 - Phone
- (458) 267-1236
- NPI assigned
- May 1, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | OR | ||
| Registered Nurse | 163W00000X | 10002172 | OR | Primary |
Addresses
Primary practice location
340 NW 5TH St Ste 204
Redmond, OR 97756-1869
Mailing address
PO Box 1710
Redmond, OR 97756-0516
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10002172 | OR | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744848000000",
"number": "1235828880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1710",
"city": "REDMOND",
"state": "OR",
"postal_code": "977560516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 NW 5TH ST STE 204",
"city": "REDMOND",
"state": "OR",
"postal_code": "977561869",
"telephone_number": "458-267-1236"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACLAIR",
"first_name": "MICA",
"middle_name": "NGOC LAN",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-01",
"last_updated": "2025-04-17",
"certification_date": "2025-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": null,
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OR",
"license": "10002172",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redmond, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.