1013087477 NPI number — MISS MEGAN PATERO HAUG LMT

Table of content: MISS MEGAN PATERO HAUG LMT (NPI 1013087477)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013087477 NPI number — MISS MEGAN PATERO HAUG LMT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAUG
Provider First Name:
MEGAN
Provider Middle Name:
PATERO
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
LMT
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:
1013087477
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/22/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3575 DONALD ST
Provider Second Line Business Mailing Address:
SUITE 640
Provider Business Mailing Address City Name:
EUGENE
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97405-4753
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-465-4864
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3575 DONALD ST
Provider Second Line Business Practice Location Address:
SUITE 640
Provider Business Practice Location Address City Name:
EUGENE
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97405-4753
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-465-4864
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/09/2006

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: 174400000X , with the licence number:  10180 , 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)

  • Identifier: 10180 . This is a "MASSAGE THERAPY LICENSE" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".




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