Provider Demographics
NPI:1295221240
Name:SZCZEBAK, MEGHAN E (PSYD - PSYCHOLOGIST)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:E
Last Name:SZCZEBAK
Suffix:
Gender:F
Credentials:PSYD - PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 NW SPRINGDALE PL
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-3337
Mailing Address - Country:US
Mailing Address - Phone:206-790-0365
Mailing Address - Fax:
Practice Address - Street 1:1506 NW SPRINGDALE PL
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98177-3337
Practice Address - Country:US
Practice Address - Phone:206-790-0365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-02
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
WAPY60404549103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist