Provider Demographics
NPI:1851657647
Name:GLUCKMAN, MEG
Entity Type:Individual
Prefix:
First Name:MEG
Middle Name:
Last Name:GLUCKMAN
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 1:6309 BEACH DR SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98136-1351
Mailing Address - Country:US
Mailing Address - Phone:206-679-0996
Mailing Address - Fax:
Practice Address - Street 1:6309 BEACH DR SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98136-1351
Practice Address - Country:US
Practice Address - Phone:206-679-0996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602664176374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula