Healthcare Provider Details

I. General information

NPI: 1528217429
Provider Name (Legal Business Name): MEGHAN NADEAU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2008
Last Update Date: 07/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1229 MADISON ST
SEATTLE WA
98104-3586
US

IV. Provider business mailing address

1229 MADISON ST
SEATTLE WA
98104-3586
US

V. Phone/Fax

Practice location:
  • Phone: 206-860-5582
  • Fax: 206-860-4750
Mailing address:
  • Phone: 206-860-5582
  • Fax: 206-860-4750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberAPPLICATION PENDING
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberMD60487152
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: