Healthcare Provider Details

I. General information

NPI: 1669879763
Provider Name (Legal Business Name): MEGAN ANN HUBBARD PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN MURPHREE

II. Dates (important events)

Enumeration Date: 12/04/2014
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2850 SE POWELL VALLEY RD
GRESHAM OR
97080-1494
US

IV. Provider business mailing address

4179 E PEAKVIEW CIR
CENTENNIAL CO
80121-3249
US

V. Phone/Fax

Practice location:
  • Phone: 503-666-5050
  • Fax: 503-666-1162
Mailing address:
  • Phone: 405-590-4654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA60990198
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0004081
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: