Provider Demographics
NPI:1255691317
Name:PLANTE, MEGAN DIANE (PT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:DIANE
Last Name:PLANTE
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 1:9700 SW CAPITOL HWY
Mailing Address - Street 2:SUITE 140
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-5294
Mailing Address - Country:US
Mailing Address - Phone:503-244-6232
Mailing Address - Fax:
Practice Address - Street 1:9700 SW CAPITOL HWY
Practice Address - Street 2:SUITE 140
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-5294
Practice Address - Country:US
Practice Address - Phone:503-244-6232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2012-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist