Provider Demographics
NPI:1912389552
Name:SMEDSRUD, MEGAN (MSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:SMEDSRUD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:BUSCHO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3813 37TH AVE S., APT LOWER
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118
Mailing Address - Country:US
Mailing Address - Phone:347-694-9260
Mailing Address - Fax:
Practice Address - Street 1:3813 37TH AVE S APT LOWER
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-1101
Practice Address - Country:US
Practice Address - Phone:347-694-9260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC605014431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical