Provider Demographics
NPI:1417283490
Name:MCNEAL, MEGAN ANN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:ANN
Last Name:MCNEAL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2852 NE 56TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-3442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1130 SW MORRISON ST
Practice Address - Street 2:SUITE 515
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2234
Practice Address - Country:US
Practice Address - Phone:503-320-4190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-26
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY 60073214103TC0700X
103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical