Provider Demographics
NPI:1447559489
Name:MEACHAM, MAEGAN NICOLE
Entity Type:Individual
Prefix:MISS
First Name:MAEGAN
Middle Name:NICOLE
Last Name:MEACHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 WILLAMETTE ST
Mailing Address - Street 2:
Mailing Address - City:UMATILLA
Mailing Address - State:OR
Mailing Address - Zip Code:97882-6601
Mailing Address - Country:US
Mailing Address - Phone:541-922-6226
Mailing Address - Fax:541-922-2732
Practice Address - Street 1:290 WILLAMETTE ST
Practice Address - Street 2:
Practice Address - City:UMATILLA
Practice Address - State:OR
Practice Address - Zip Code:97882-6601
Practice Address - Country:US
Practice Address - Phone:541-922-6226
Practice Address - Fax:541-922-2732
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker