Provider Demographics
NPI:1619508108
Name:AMES, MEGAN ROSE (CNM)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ROSE
Last Name:AMES
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:R
Other - Last Name:GORDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:550 GAGE BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-9532
Mailing Address - Country:US
Mailing Address - Phone:509-942-3627
Mailing Address - Fax:509-627-2983
Practice Address - Street 1:945 GOETHALS DR STE 200
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3552
Practice Address - Country:US
Practice Address - Phone:509-942-2555
Practice Address - Fax:509-942-2340
Is Sole Proprietor?:No
Enumeration Date:2020-02-03
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61010391367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife