Healthcare Provider Details

I. General information

NPI: 1497933386
Provider Name (Legal Business Name): MEGAN R BISHOP AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2008
Last Update Date: 03/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 W RIVERSIDE AVE SUITE 304
SPOKANE WA
99201-0405
US

IV. Provider business mailing address

3403 N PINE HILL PL
COEUR D ALENE ID
83815-6608
US

V. Phone/Fax

Practice location:
  • Phone: 949-282-1212
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number22704
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: