Healthcare Provider Details

I. General information

NPI: 1144192097
Provider Name (Legal Business Name): MEGHAN LEEVES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2025
Last Update Date: 09/20/2025
Certification Date: 09/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 12TH ST
HOOD RIVER OR
97031-1587
US

IV. Provider business mailing address

1416 TAYLOR AVE APT B
HOOD RIVER OR
97031-1546
US

V. Phone/Fax

Practice location:
  • Phone: 541-386-3911
  • Fax:
Mailing address:
  • Phone: 936-206-8857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number10003169
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: