Individual
MEGAN LYNN CHARBONEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3801 5TH ST SE, SUITE 110, PUYALLUP, WA 98374-2106
(253) 845-9585
(253) 848-1126
Mailing address
805 MADISON ST, SUITE 901, SEATTLE, WA 98104-1172
(206) 264-8100
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
52937
WI
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
BC60578430
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033233374
—
WI
Enumeration date
08/22/2006
Last updated
07/22/2015
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