Provider Demographics
NPI:1063842730
Name:GOULDIN, MEGAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:
Last Name:GOULDIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:HOOVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1120 GRANT RD
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-5243
Mailing Address - Country:US
Mailing Address - Phone:509-884-7163
Mailing Address - Fax:509-884-2363
Practice Address - Street 1:1120 GRANT RD
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-5243
Practice Address - Country:US
Practice Address - Phone:150-988-4163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-17
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60355950111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor