Provider Demographics
NPI:1174494660
Name:DEMASKEY, MEGAN LEIGH (MASSMA)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:LEIGH
Last Name:DEMASKEY
Suffix:
Gender:F
Credentials:MASSMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3409 NE 62ND AVE # H79
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-0207
Mailing Address - Country:US
Mailing Address - Phone:360-558-9477
Mailing Address - Fax:
Practice Address - Street 1:12116 SE MILL PLAIN BLVD STE 2
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-6000
Practice Address - Country:US
Practice Address - Phone:360-764-0753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMASS.MA.7002855225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist