Provider Demographics
NPI:1063958965
Name:DINSMORE, MEGAN
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:DINSMORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9810 SW 238TH ST
Mailing Address - Street 2:
Mailing Address - City:VASHON
Mailing Address - State:WA
Mailing Address - Zip Code:98070-7052
Mailing Address - Country:US
Mailing Address - Phone:206-422-9070
Mailing Address - Fax:
Practice Address - Street 1:2747 PACIFIC AVE SE
Practice Address - Street 2:SUITE A10-11
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-2097
Practice Address - Country:US
Practice Address - Phone:360-915-5346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst