Provider Demographics
NPI:1285366237
Name:BUTTERWECK, MEGAN JANE (OTD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:JANE
Last Name:BUTTERWECK
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:DR
Other - First Name:MEGAN
Other - Middle Name:JANE
Other - Last Name:BUTTERWECK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTD
Mailing Address - Street 1:11866 MOUNT HARVARD CT
Mailing Address - Street 2:
Mailing Address - City:ALTA LOMA
Mailing Address - State:CA
Mailing Address - Zip Code:91737-7913
Mailing Address - Country:US
Mailing Address - Phone:909-371-9147
Mailing Address - Fax:
Practice Address - Street 1:200 NAT WASHINGTON WAY
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:WA
Practice Address - Zip Code:98823-1997
Practice Address - Country:US
Practice Address - Phone:509-754-4631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPENDING225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist