Provider Demographics
NPI:1255321618
Name:BRISTOW, MEGAN (OTRL)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:BRISTOW
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:FRENCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L, CHT
Mailing Address - Street 1:PO BOX 421
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-0421
Mailing Address - Country:US
Mailing Address - Phone:866-747-2455
Mailing Address - Fax:509-944-9644
Practice Address - Street 1:16528 E DESMET CT STE B2200
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-3522
Practice Address - Country:US
Practice Address - Phone:509-944-8920
Practice Address - Fax:509-227-7070
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00003865225X00000X, 225XE1200X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XE1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistErgonomics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8390395Medicaid
WACN2416OtherRAILROAD MEDICARE GROUP
WAP00146690OtherRAILROAD MEDICARE INDIVIDUAL
WA650009047OtherRAILROAD MEDICARE
WAP00146690OtherRAILROAD MEDICARE INDIVIDUAL
WA650009047OtherRAILROAD MEDICARE
WA8804271Medicare ID - Type Unspecified