Provider Demographics
NPI:1114630563
Name:COUTURE, MEGAN TAYLOR (MPH, MA)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:TAYLOR
Last Name:COUTURE
Suffix:
Gender:F
Credentials:MPH, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 NW 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-2829
Mailing Address - Country:US
Mailing Address - Phone:503-525-0090
Mailing Address - Fax:
Practice Address - Street 1:933 NW 25TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-2829
Practice Address - Country:US
Practice Address - Phone:503-525-0090
Practice Address - Fax:971-244-0219
Is Sole Proprietor?:No
Enumeration Date:2022-12-30
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR101YM0800X
ORR8105101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health