Provider Demographics
NPI:1548381064
Name:WOODRUFF-DISHMAN, MEAGHAN HALL (ND, LAC, MSOM)
Entity Type:Individual
Prefix:MRS
First Name:MEAGHAN
Middle Name:HALL
Last Name:WOODRUFF-DISHMAN
Suffix:
Gender:F
Credentials:ND, LAC, MSOM
Other - Prefix:DR
Other - First Name:MEAGHAN
Other - Middle Name:HALL
Other - Last Name:DISHMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ND, LAC, MSOM
Mailing Address - Street 1:3313 NW SHEVLIN RDG
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-7752
Mailing Address - Country:US
Mailing Address - Phone:919-397-1012
Mailing Address - Fax:888-304-9394
Practice Address - Street 1:550 SW INDUSTRIAL WAY, BUILDING 2
Practice Address - Street 2:SUITE 100
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702
Practice Address - Country:US
Practice Address - Phone:541-312-9838
Practice Address - Fax:541-312-9839
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC596171100000X
ORAC00910171100000X
OR1446175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist