Provider Demographics
NPI:1760281224
Name:MEAGHER, MARYKATE (NP)
Entity type:Individual
Prefix:
First Name:MARYKATE
Middle Name:
Last Name:MEAGHER
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4991 NW ZAMIA LN
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-7544
Mailing Address - Country:US
Mailing Address - Phone:207-939-2667
Mailing Address - Fax:
Practice Address - Street 1:4991 NW ZAMIA LN
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-7544
Practice Address - Country:US
Practice Address - Phone:207-939-2667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10012098363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily