Individual
MEGAN EVANGELINE FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, RN, CCM
Contact information
Practice address
217 MT ECHO DR, MEDFORD, OR 97504-7500
(206) 478-3663
Mailing address
217 MT ECHO DR, MEDFORD, OR 97504-7500
(206) 478-3663
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00173036
WA
163W00000X
Registered Nurse
Primary
RN10018746
OR
Other
Enumeration date
09/10/2025
Last updated
09/10/2025
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