Provider Demographics
NPI:1154750107
Name:BRISTOW, MEGAN KRISTA FEE (MT-BC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:KRISTA FEE
Last Name:BRISTOW
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:KRISTA
Other - Last Name:FEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14360 SE EASTGATE WAY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-6462
Mailing Address - Country:US
Mailing Address - Phone:425-644-0988
Mailing Address - Fax:425-644-0989
Practice Address - Street 1:14360 SE EASTGATE WAY
Practice Address - Street 2:SUITE 102
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-6462
Practice Address - Country:US
Practice Address - Phone:425-644-0988
Practice Address - Fax:425-644-0989
Is Sole Proprietor?:No
Enumeration Date:2013-11-09
Last Update Date:2013-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist