Provider Demographics
NPI:1306929526
Name:SNOW SIMPKIN, MEGAN K (MS, CRC, NCC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:K
Last Name:SNOW SIMPKIN
Suffix:
Gender:F
Credentials:MS, CRC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13037
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-0037
Mailing Address - Country:US
Mailing Address - Phone:503-746-3373
Mailing Address - Fax:503-300-4473
Practice Address - Street 1:7346 NE SANDY BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-5775
Practice Address - Country:US
Practice Address - Phone:503-746-3373
Practice Address - Fax:503-583-8305
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2714-154235Z00000X
OR013097235Z00000X
ORR9527101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR013097OtherBOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY
ORR9527OtherBOARD OF LICENSED PROFESSIONAL COUNSELORS AND THERAPISTS