=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679362792
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MEGAN LYNN WIGGINS LMHCA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/05/2025
-----------------------------------------------------
Last Update Date | 05/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1498 SE TECH CENTER PL
-----------------------------------------------------
City | VANCOUVER
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98683-9591
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-619-2226
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3508 NW 161ST WAY
-----------------------------------------------------
City | RIDGEFIELD
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98642-8289
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-560-9931
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | MC61639797
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------