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NPI Code Detail

MEDICARE: MEGAN BRUCE

MEDICARE:   MEGAN  BRUCE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerL3593OR

General Provider Information

NPI Number : 1235341652
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN BRUCE
Provider Business Mailing Address
First Line : 3926 NE 10TH AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97212-1221
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1305 NE FREMONT ST
Second Line :
City : PORTLAND
State : OR
Zip : 97212-2218
Country : US
Telephone Number : 503-961-4254
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2007
Last Update Date : 03/09/2010

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Directions to “ MEGAN BRUCE ” Practice Location

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