Provider Demographics
NPI:1336906700
Name:CASE, MEGAN ALISSA (CNM)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ALISSA
Last Name:CASE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:ALISSA
Other - Last Name:MORTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3774 NW RIDGEWAY CIR
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-1712
Mailing Address - Country:US
Mailing Address - Phone:360-620-5110
Mailing Address - Fax:
Practice Address - Street 1:9750 LEVIN RD NW
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8399
Practice Address - Country:US
Practice Address - Phone:360-307-7202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61511274363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology