Provider Demographics
NPI:1558659763
Name:ALEF, MEGHAN PATRICE (LMT)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:PATRICE
Last Name:ALEF
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1323 SUMMIT LAKE SHORE RD NW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-9485
Mailing Address - Country:US
Mailing Address - Phone:503-757-7723
Mailing Address - Fax:
Practice Address - Street 1:1323 SUMMIT LAKE SHORE RD NW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-9485
Practice Address - Country:US
Practice Address - Phone:503-287-2787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-21
Last Update Date:2011-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR17319225700000X
WA60251402225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist