Healthcare Provider Details

I. General information

NPI: 1578916383
Provider Name (Legal Business Name): MEGAN GASCHK PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2016
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 HOSPITAL LOOP
FAIRCHILD AFB WA
99011-8704
US

IV. Provider business mailing address

701 HOSPITAL LOOP
FAIRCHILD AFB WA
99011-8704
US

V. Phone/Fax

Practice location:
  • Phone: 509-247-2731
  • Fax: 509-247-4499
Mailing address:
  • Phone: 509-247-2731
  • Fax: 509-247-4499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number60963009
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: