Provider Demographics
NPI:1831628544
Name:KNIGHT, MEGAN (SLP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 NW 16TH CIR
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-6818
Mailing Address - Country:US
Mailing Address - Phone:360-977-1967
Mailing Address - Fax:
Practice Address - Street 1:400 E EVERGREEN BLVD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-3331
Practice Address - Country:US
Practice Address - Phone:360-524-6167
Practice Address - Fax:360-282-1029
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-06
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR16257235Z00000X
WALL60841878235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist