Provider Demographics
NPI:1245576628
Name:FRAZIER, DIANE M Z (MS,CCC)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:M Z
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:MS,CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15720 NE 25TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-8600
Mailing Address - Country:US
Mailing Address - Phone:360-604-1101
Mailing Address - Fax:
Practice Address - Street 1:13501 NE 28TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98682-8091
Practice Address - Country:US
Practice Address - Phone:360-604-3925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-12
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist