Provider Demographics
NPI:1689448813
Name:NEWMAN, MEGAN ROSE (CNA)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ROSE
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:COLBY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNA
Mailing Address - Street 1:7029 NE 152ND PL
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-7040
Mailing Address - Country:US
Mailing Address - Phone:360-991-1228
Mailing Address - Fax:
Practice Address - Street 1:2621 NE 134TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98686-3036
Practice Address - Country:US
Practice Address - Phone:360-360-1831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60800029374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide