Provider Demographics
NPI:1386681203
Name:DUGGAN, MAUREEN KAREN (MS, EDS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:KAREN
Last Name:DUGGAN
Suffix:
Gender:F
Credentials:MS, EDS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7515 50TH ST W
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98467-4573
Mailing Address - Country:US
Mailing Address - Phone:253-327-3760
Mailing Address - Fax:
Practice Address - Street 1:7515 50TH ST W
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98467-4573
Practice Address - Country:US
Practice Address - Phone:253-327-3760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDSLP-1235235Z00000X
WALL60101638235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist