Provider Demographics
NPI:1598868374
Name:LINDALE, MEGAN DIANA (ARNP)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:DIANA
Last Name:LINDALE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 N DIVISION ST
Mailing Address - Street 2:PLAZA 2, SUITE 202
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-4939
Mailing Address - Country:US
Mailing Address - Phone:253-876-0760
Mailing Address - Fax:253-876-0771
Practice Address - Street 1:202 N DIVISION ST
Practice Address - Street 2:PLAZA 2, SUITE 202
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-4939
Practice Address - Country:US
Practice Address - Phone:253-876-0760
Practice Address - Fax:253-876-0771
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004653363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP61115Medicare UPIN