Individual
MEGAN DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
3518 6TH AVE STE 200A, TACOMA, WA 98406-5419
(253) 507-7121
(253) 267-1607
Mailing address
3518 6TH AVE STE 200A, TACOMA, WA 98406-5419
(253) 507-7121
(253) 267-1607
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
HP10001388
WA
174400000X
Specialist
Primary
MA00018906
WA
174400000X
Specialist
RC00046696
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0177904
DOLI
WA
01
—
0194713
DOLI CLINIC ID
WA
Enumeration date
11/10/2006
Last updated
12/16/2021
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