Provider Demographics
NPI:1649430505
Name:MEGAN J. OSBORN, PMHNP/ANP, PC
Entity type:Organization
Organization Name:MEGAN J. OSBORN, PMHNP/ANP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:JOANNA
Authorized Official - Last Name:OSBORN
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP/ANP
Authorized Official - Phone:503-399-8200
Mailing Address - Street 1:PO BOX 2719
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97308-2719
Mailing Address - Country:US
Mailing Address - Phone:503-399-8200
Mailing Address - Fax:503-363-2600
Practice Address - Street 1:1505 WATER ST NE
Practice Address - Street 2:SUITE 2
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-6467
Practice Address - Country:US
Practice Address - Phone:503-399-8200
Practice Address - Fax:503-363-2600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR081000718N3363LA2200X
OR200450036NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty