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NPI Code Detail

MEDICARE: MEGAN LEE LEDYARD PT

MEDICARE: MEGAN LEE LEDYARD PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist4129OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780668723
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN LEE LEDYARD PT
Provider Business Mailing Address
First Line : 11481 SW HALL BLVD
Second Line : STE 201
City : PORTLAND
State : OR
Zip : 97223-8403
Country : US
Telephone Number : 800-219-8835
Fax Number : 503-443-1402
Provider Business Practice Location Address
First Line : 2600 NE NEFF RD
Second Line :
City : BEND
State : OR
Zip : 97701-6337
Country : US
Telephone Number : 541-706-6843
Fax Number : 541-598-3444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2005
Last Update Date : 02/12/2024

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