Charboneau, Megan Lynn

Charboneau, Megan Lynn is an individual health care provider with primary practice located at 3801 5Th St Se Suite 110, Puyallup WA 98374-2106. She recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as her primary health care specialty. Charboneau, Megan Lynn can be contacted via phone (253) 845-9585.

Contact Information

Primary practice address
3801 5Th St Se Suite 110 Puyallup WA 98374-2106
Phone: (253) 845-9585
Fax: (253) 848-1126
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 52937 Wisconsin
Allopathic & Osteopathic Physicians / Sports Medicine 2081S0010X BC60578430 Washington

Profile Details

NPI number 1922114701
LBN Legal business name Charboneau, Megan Lynn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 22nd, 2006
Last updated Jul 22nd, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922114701 NPPES
Wisconsin MEDICAID 1033233374

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