1528036027 NPI number — MRS. MEGAN ELIZABETH COX PT

Table of content: MRS. MEGAN ELIZABETH COX PT (NPI 1528036027)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528036027 NPI number — MRS. MEGAN ELIZABETH COX PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COX
Provider First Name:
MEGAN
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528036027
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/20/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25030 SW PARKWAY AVE
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
WILSONVILLE
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97070-9816
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-582-1073
Provider Business Mailing Address Fax Number:
503-582-1093

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1554 GARDEN ST STE 103
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST LINN
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97068-3278
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-723-0347
Provider Business Practice Location Address Fax Number:
503-655-9305
Provider Enumeration Date:
03/09/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  4761 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)