Provider Demographics
NPI:1699173740
Name:FERRIS, MEGAN MARIE
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARIE
Last Name:FERRIS
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 1:17700 SE 272ND ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-4951
Mailing Address - Country:US
Mailing Address - Phone:253-372-7030
Mailing Address - Fax:253-372-7032
Practice Address - Street 1:17700 SE 272ND ST
Practice Address - Street 2:SUITE 110
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-4951
Practice Address - Country:US
Practice Address - Phone:253-372-7030
Practice Address - Fax:253-372-7032
Is Sole Proprietor?:No
Enumeration Date:2014-12-05
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60473678225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist