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General NPI Number Information
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NPI Number | 1083509319
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Entity Type | Organization
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Legal Business Name | PEARL FAMILY MEDICINE
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 1400 NE 136TH AVE STE 201
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City | VANCOUVER
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State | WA
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Zip | 98684-0993
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Country | US
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Telephone | 360-299-5529
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Fax | 608-830-9093
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Provider Business Mailing Address
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Address Line | 1902 NW 26TH AVE
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City | BATTLE GROUND
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State | WA
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Zip | 98604-8296
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Country | US
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Telephone | 360-947-7252
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MEGAN GALLEGOS
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Credential | FNP
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Telephone | 360-947-7252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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