Provider Demographics
NPI:1457817769
Name:SARLES, MEGAN CHESNEY
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:CHESNEY
Last Name:SARLES
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 1:18875 NW UKIAH ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-3231
Mailing Address - Country:US
Mailing Address - Phone:503-269-2941
Mailing Address - Fax:
Practice Address - Street 1:190 SE 8TH AVE
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4216
Practice Address - Country:US
Practice Address - Phone:503-269-2941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-12
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program