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General NPI Number Information
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NPI Number | 1487347811
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Entity Type | Individual
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Provider Name | MEGHAN LUNDEEN PENCE MA
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Gender | Female
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Dates
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Enumeration Date | 05/31/2023
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Last Update Date | 05/31/2023
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Provider Practice Location Address
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Address Line | 19824 SW 72ND AVE STE 102
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City | TUALATIN
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State | OR
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Zip | 97062-8398
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Country | US
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Telephone | 503-908-9084
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Fax |
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Provider Business Mailing Address
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Address Line | 588 9TH ST
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City | LAKE OSWEGO
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State | OR
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Zip | 97034-2915
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Country | US
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Telephone | 503-989-1050
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | R8329
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License Number State | OR
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