Provider Demographics
NPI:1528034840
Name:MILYARD, MEGAN MARIE (OTRL)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:MARIE
Last Name:MILYARD
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:MARIE
Other - Last Name:MUNRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19351 8TH AVE NE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-8710
Mailing Address - Country:US
Mailing Address - Phone:360-697-3003
Mailing Address - Fax:360-697-3026
Practice Address - Street 1:19351 8TH AVE NE
Practice Address - Street 2:SUITE 200
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-8710
Practice Address - Country:US
Practice Address - Phone:360-697-3003
Practice Address - Fax:360-697-3026
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00002325225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist