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NPI Code Detail

MEDICARE: MEGAN EMILY THYGESEN MD

MEDICARE: MEGAN EMILY THYGESEN MD
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
1207R00000XInternal Medicine PhysicianMD24260OR
2207RG0300XGeriatric Medicine (Internal Medicine) PhysicianMD24260OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851341507
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN EMILY THYGESEN MD
Provider Business Mailing Address
First Line : 1200 NW 23RD AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97210-2906
Country : US
Telephone Number : 503-413-7074
Fax Number :
Provider Business Practice Location Address
First Line : 1200 NW 23RD AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97210-2906
Country : US
Telephone Number : 503-413-7074
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 05/21/2008

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