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General NPI Number Information
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NPI Number | 1396381653
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Entity Type | Organization
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Legal Business Name | MEGHAN DEVONPORT, LMP
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Dates
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Enumeration Date | 11/21/2019
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Last Update Date | 11/21/2019
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Provider Practice Location Address
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Address Line | 1417 NW 54TH ST STE 455
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City | SEATTLE
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State | WA
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Zip | 98107-3564
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Country | US
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Telephone | 561-843-5935
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Fax |
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Provider Business Mailing Address
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Address Line | 3318 159TH LN SW
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City | LYNNWOOD
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State | WA
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Zip | 98087-1545
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Country | US
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Telephone | 561-843-5935
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Fax |
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Authorized Official
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Title or Position | MASSAGE THERAPIST/BUSINESS OWNER
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Name | MRS. MEGHAN DEVONPORT
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Credential | LMP
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Telephone | 561-843-5935
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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