Provider Demographics
NPI:1588700413
Name:GREENLAW, MEGAN JOY (MA)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:JOY
Last Name:GREENLAW
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14655 NE BEL RED RD OFC PARK
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-3900
Mailing Address - Country:US
Mailing Address - Phone:425-233-8129
Mailing Address - Fax:
Practice Address - Street 1:14655 NE BEL RED RD OFC PARK
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3900
Practice Address - Country:US
Practice Address - Phone:425-233-8129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2021-10-27
Deactivation Date:2021-05-21
Deactivation Code:
Reactivation Date:2021-06-22
Provider Licenses
StateLicense IDTaxonomies
WAMC61158869101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health