Healthcare Provider Details

I. General information

NPI: 1881022051
Provider Name (Legal Business Name): MEGHAN BRIANNA O'LOUGHLIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2013
Last Update Date: 10/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14085 SW TEAL BLVD APT 45E
BEAVERTON OR
97008-9205
US

IV. Provider business mailing address

14085 SW TEAL BLVD APT 45E
BEAVERTON OR
97008-9205
US

V. Phone/Fax

Practice location:
  • Phone: 503-702-8514
  • Fax:
Mailing address:
  • Phone: 503-702-8514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number200943114RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: