Provider Demographics
NPI:1811063035
Name:BEERS, MEGAN ELIZABETH (PHD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:BEERS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:ELIZABETH
Other - Last Name:MCDADE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 5TH AVE
Mailing Address - Street 2:SUITE 800
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-3132
Mailing Address - Country:US
Mailing Address - Phone:206-374-0109
Mailing Address - Fax:206-374-0108
Practice Address - Street 1:1200 5TH AVE
Practice Address - Street 2:SUITE 800
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-3132
Practice Address - Country:US
Practice Address - Phone:206-374-0109
Practice Address - Fax:206-374-0108
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS01163103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR037759Medicaid
RIPS01163OtherRI LICENSE