Provider Demographics
NPI:1558897504
Name:DUCAR, CINDY
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:DUCAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6811 PINEHURST AVE SE
Mailing Address - Street 2:
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-9010
Mailing Address - Country:US
Mailing Address - Phone:310-897-1650
Mailing Address - Fax:
Practice Address - Street 1:6811 PINEHURST AVE SE
Practice Address - Street 2:
Practice Address - City:SNOQUALMIE
Practice Address - State:WA
Practice Address - Zip Code:98065-9010
Practice Address - Country:US
Practice Address - Phone:310-897-1650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL 60740403235Z00000X
CASP 21493235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist