Provider Demographics
NPI:1568733905
Name:MILES, MEGAN ELAINE
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ELAINE
Last Name:MILES
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 1:5217 74TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-6940
Mailing Address - Country:US
Mailing Address - Phone:360-659-7357
Mailing Address - Fax:
Practice Address - Street 1:5217 74TH AVE NE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-6940
Practice Address - Country:US
Practice Address - Phone:360-659-7357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-17
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula