Provider Demographics
NPI:1932464187
Name:MCGILL, MEGANN NICOLE (PHD, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MEGANN
Middle Name:NICOLE
Last Name:MCGILL
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 MEADOWS RD STE 150
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-0066
Mailing Address - Country:US
Mailing Address - Phone:956-245-7000
Mailing Address - Fax:
Practice Address - Street 1:5200 MEADOWS RD STE 150
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-0066
Practice Address - Country:US
Practice Address - Phone:956-245-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106780235Z00000X
OR015831235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist