Provider Demographics
NPI:1154297422
Name:KASSNER, MEAGEN
Entity type:Individual
Prefix:
First Name:MEAGEN
Middle Name:
Last Name:KASSNER
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 1:3606 ASH ST
Mailing Address - Street 2:
Mailing Address - City:FOREST GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97116-3357
Mailing Address - Country:US
Mailing Address - Phone:602-885-8930
Mailing Address - Fax:
Practice Address - Street 1:3606 ASH ST
Practice Address - Street 2:
Practice Address - City:FOREST GROVE
Practice Address - State:OR
Practice Address - Zip Code:97116-3357
Practice Address - Country:US
Practice Address - Phone:602-885-8930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-14
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health