Provider Demographics
NPI:1043395106
Name:NAVISH, MEGHAN HILLARY (PT)
Entity Type:Individual
Prefix:MS
First Name:MEGHAN
Middle Name:HILLARY
Last Name:NAVISH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 NE WYATT CT
Mailing Address - Street 2:STE 103
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-7679
Mailing Address - Country:US
Mailing Address - Phone:541-383-8179
Mailing Address - Fax:
Practice Address - Street 1:330 NE MARSHALL AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4346
Practice Address - Country:US
Practice Address - Phone:541-383-8179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2298225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR131174Medicare ID - Type Unspecified