Healthcare Provider Details

I. General information

NPI: 1720730393
Provider Name (Legal Business Name): MEGAN ASHLEY GALLEGOS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN GALLEGOS RN, FNP

II. Dates (important events)

Enumeration Date: 01/25/2022
Last Update Date: 05/11/2025
Certification Date: 05/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 NE 136TH AVE
VANCOUVER WA
98684-0993
US

IV. Provider business mailing address

1400 NE 136TH AVE
VANCOUVER WA
98684-0993
US

V. Phone/Fax

Practice location:
  • Phone: 360-299-5529
  • Fax:
Mailing address:
  • Phone: 360-947-7252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP61657502
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60311875
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: