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General NPI Number Information
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NPI Number | 1396100459
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Entity Type | Individual
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Provider Name | MEGAN WILSON FNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/16/2015
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Last Update Date | 06/01/2018
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Provider Practice Location Address
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Address Line | 19400 NW EVERGREEN PKWY
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City | HILLSBORO
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State | OR
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Zip | 97124
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Country | US
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Telephone | 971-310-2335
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3777
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City | PORTLAND
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State | OR
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Zip | 97208-3777
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Country | US
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Telephone | 503-413-3900
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP60626059
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201507316NP-PP
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License Number State | OR
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