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General NPI Number Information
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NPI Number | 1740421007
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Entity Type | Individual
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Provider Name | MEGAN ELIZABETH GLEASON MPT
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Gender | Female
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Dates
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Enumeration Date | 03/17/2009
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Last Update Date | 03/17/2009
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Provider Practice Location Address
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Address Line | 3025 SW RESERVOIR RD
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City | REDMOND
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State | OR
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Zip | 97756-9481
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Country | US
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Telephone | 541-548-5066
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Fax | 541-548-8302
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Provider Business Mailing Address
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Address Line | 3025 SW RESERVOIR RD
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City | REDMOND
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State | OR
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Zip | 97756-9481
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Country | US
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Telephone | 541-548-5066
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Fax | 541-548-8302
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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 | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | 5180
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License Number State | OR
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