Healthcare Provider Details

I. General information

NPI: 1699256479
Provider Name (Legal Business Name): MEGAN ELIZABETH CUEVAS ARNP, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2018
Last Update Date: 08/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 BLACK LAKE BLVD SW
OLYMPIA WA
98512-5651
US

IV. Provider business mailing address

1920 BLACK LAKE BLVD SW # WA98512
OLYMPIA WA
98512-5651
US

V. Phone/Fax

Practice location:
  • Phone: 360-534-9222
  • Fax:
Mailing address:
  • Phone: 360-534-9222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP60833514
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: