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General NPI Number Information
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NPI Number | 1235770280
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Entity Type | Individual
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Provider Name | MEGAN BRUCE NP
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Gender | Female
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Dates
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Enumeration Date | 10/01/2019
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Last Update Date | 08/20/2021
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Provider Practice Location Address
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Address Line | 16144 SE HAPPY VALLEY TOWN CENTER DR STE 101
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City | HAPPY VALLEY
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State | OR
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Zip | 97086-4257
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Country | US
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Telephone | 503-659-4988
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Fax | 503-698-4018
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Provider Business Mailing Address
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Address Line | PO BOX 22075
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City | MILWAUKIE
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State | OR
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Zip | 97269-2075
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Country | US
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Telephone | 503-659-4988
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Fax | 503-698-4018
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201908774NP-PP
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License Number State | OR
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