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NPI Code Detail

MEDICARE: MRS. MEGAN DALE MARTIN

MEDICARE: MRS. MEGAN DALE MARTIN
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
1106S00000XBehavior TechnicianWA

General Provider Information

NPI Number : 1508792433
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MEGAN DALE MARTIN
Provider Business Mailing Address
First Line : 8819 31ST AVE NE APT 405
Second Line :
City : LACEY
State : WA
Zip : 98516-3223
Country : US
Telephone Number : 425-870-7522
Fax Number :
Provider Business Practice Location Address
First Line : 1217 COOPER POINT RD SW STE 5
Second Line :
City : OLYMPIA
State : WA
Zip : 98502-7206
Country : US
Telephone Number : 360-464-9052
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2026
Last Update Date : 06/19/2026

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Directions to “ MRS. MEGAN DALE MARTIN ” Practice Location

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