Individual
MEGANN IMDIEKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2715 LILAC ST, LONGVIEW, WA 98632-3526
(360) 575-7307
Mailing address
16313 NE 34TH ST, VANCOUVER, WA 98682-8659
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
465514H
WA
Other
Enumeration date
10/27/2015
Last updated
10/27/2015
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