Provider Demographics
NPI:1487818464
Name:SAPP, MEGAN AMANDA (CNM)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:AMANDA
Last Name:SAPP
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:SAPP
Other - Last Name:MADSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7650 SW BEVELAND RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8692
Mailing Address - Country:US
Mailing Address - Phone:503-249-5454
Mailing Address - Fax:503-249-5498
Practice Address - Street 1:10566 SE WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-2809
Practice Address - Country:US
Practice Address - Phone:503-249-5454
Practice Address - Fax:503-249-5498
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61406275363LP0808X
OR201401213NPPP363LP0808X
OR201401213NP367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500668743Medicaid
ORR179665OtherMEDICARE PTAN