Provider Demographics
NPI:1124410618
Name:BANCROFT, MEGAN K (SLP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:K
Last Name:BANCROFT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:K
Other - Last Name:STECKBAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 25608
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84125-0608
Mailing Address - Country:US
Mailing Address - Phone:206-320-4476
Mailing Address - Fax:206-568-7043
Practice Address - Street 1:1229 MADISON ST
Practice Address - Street 2:1500
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3586
Practice Address - Country:US
Practice Address - Phone:206-386-3592
Practice Address - Fax:206-386-6657
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-20
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA235Z00000X
WALL 60620325235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist