Provider Demographics
NPI:1467907709
Name:THAL, MEGAN LINDSAY
Entity Type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:LINDSAY
Last Name:THAL
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 1:4120 STONE WAY N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8014
Mailing Address - Country:US
Mailing Address - Phone:206-545-8613
Mailing Address - Fax:206-632-2437
Practice Address - Street 1:4120 STONE WAY N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8014
Practice Address - Country:US
Practice Address - Phone:206-545-8613
Practice Address - Fax:206-632-2437
Is Sole Proprietor?:No
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG 60150269101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor