Provider Demographics
NPI:1275241010
Name:SWENSON, MEGAN LEIGH (MSN, RN)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:LEIGH
Last Name:SWENSON
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:LEIGH
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1000 THIRD STREET
Mailing Address - Street 2:
Mailing Address - City:TILLAMOOK
Mailing Address - State:OR
Mailing Address - Zip Code:97141
Mailing Address - Country:US
Mailing Address - Phone:503-815-7561
Mailing Address - Fax:503-815-7595
Practice Address - Street 1:1000 THIRD STREET
Practice Address - Street 2:
Practice Address - City:TILLAMOOK
Practice Address - State:OR
Practice Address - Zip Code:97141
Practice Address - Country:US
Practice Address - Phone:503-815-7561
Practice Address - Fax:503-815-7595
Is Sole Proprietor?:No
Enumeration Date:2022-11-10
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200241209RN163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management