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NPI Code Detail

MEDICARE: MEGAN PADILLA PSY.D.

MEDICARE: MEGAN PADILLA PSY.D.
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
1103TC0700XClinical Psychologist3162OR

General Provider Information

NPI Number : 1710330816
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN PADILLA PSY.D.
Provider Business Mailing Address
First Line : 4799 SW GREENSBORO WAY APT 58
Second Line :
City : BEAVERTON
State : OR
Zip : 97078-2789
Country : US
Telephone Number : 602-570-0252
Fax Number :
Provider Business Practice Location Address
First Line : 2222 E POWELL BLVD
Second Line :
City : GRESHAM
State : OR
Zip : 97080-1365
Country : US
Telephone Number : 503-669-4300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2016
Last Update Date : 12/17/2019

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