Provider Demographics
NPI:1851840979
Name:MEGAN DYE
Entity Type:Organization
Organization Name:MEGAN DYE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DYE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:360-909-4646
Mailing Address - Street 1:7600 NE 41ST ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6728
Mailing Address - Country:US
Mailing Address - Phone:360-253-6425
Mailing Address - Fax:360-253-3196
Practice Address - Street 1:210 NW 153RD ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-1796
Practice Address - Country:US
Practice Address - Phone:360-909-4646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-30
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60342799261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health