Provider Demographics
NPI:1013087477
Name:HAUG, MEGAN PATERO (LMT)
Entity Type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:PATERO
Last Name:HAUG
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3575 DONALD ST
Mailing Address - Street 2:SUITE 640
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-4753
Mailing Address - Country:US
Mailing Address - Phone:541-465-4864
Mailing Address - Fax:
Practice Address - Street 1:3575 DONALD ST
Practice Address - Street 2:SUITE 640
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-4753
Practice Address - Country:US
Practice Address - Phone:541-465-4864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10180174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR10180OtherMASSAGE THERAPY LICENSE