Provider Demographics
NPI:1760945638
Name:DOUGLAS, MEGAN (LACTATION CONSULTANT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:DOUGLAS
Suffix:
Gender:F
Credentials:LACTATION CONSULTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9619 E MILL PLAIN BLVD APT A
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-3400
Mailing Address - Country:US
Mailing Address - Phone:360-721-5975
Mailing Address - Fax:
Practice Address - Street 1:9619 E MILL PLAIN BLVD APT A
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-3400
Practice Address - Country:US
Practice Address - Phone:360-721-5975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-09
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN