MEDICARE: MEGAN DANIELLE ANTHONY DO

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
1	207R00000X	Internal Medicine Physician	236757	AK
2	207R00000X	Internal Medicine Physician	DO215226	OR
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1972130847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN DANIELLE ANTHONY DO

Provider Business Mailing Address
First Line	:	3850 KITSAP WAY STE 104
Second Line	:
City	:	BREMERTON
State	:	WA
Zip	:	98312-2463
Country	:	US
Telephone Number	:	360-375-2240
Fax Number	:	800-861-4954

Provider Business Practice Location Address
First Line	:	3850 KITSAP WAY STE 104
Second Line	:
City	:	BREMERTON
State	:	WA
Zip	:	98312-2463
Country	:	US
Telephone Number	:	360-375-2240
Fax Number	:	800-861-4954

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2020
Last Update Date	:	05/12/2026

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