Provider Demographics
NPI:1194442103
Name:MCGLAMERY, MEGAN A
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:A
Last Name:MCGLAMERY
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 1:1455 S PUGET DR APT E204
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-8852
Mailing Address - Country:US
Mailing Address - Phone:719-621-0522
Mailing Address - Fax:
Practice Address - Street 1:1455 S PUGET DR APT E204
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-8852
Practice Address - Country:US
Practice Address - Phone:719-621-0522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician