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General NPI Number Information
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NPI Number | 1497975114
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Entity Type | Individual
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Provider Name | MEGAN CHRISTINE GILLESPIE LMP
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Gender | Female
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 05/06/2008
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Provider Practice Location Address
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Address Line | 2217 N ASHLAND AVE
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City | EAST WENATCHEE
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State | WA
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Zip | 98802-4012
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Country | US
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Telephone | 509-264-8767
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Fax |
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Provider Business Mailing Address
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Address Line | 331 VALLEY MALL PKWY # 338
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City | EAST WENATCHEE
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State | WA
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Zip | 98802-4831
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Country | US
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Telephone | 509-264-8767
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | MA00021074
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License Number State | WA
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