Provider Demographics
NPI:1689864258
Name:MCSPADEN, DANA KIRSTEN (MS,CCC-SLP/AUD)
Entity Type:Individual
Prefix:MS
First Name:DANA
Middle Name:KIRSTEN
Last Name:MCSPADEN
Suffix:
Gender:F
Credentials:MS,CCC-SLP/AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 JUDSON ST S
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-5309
Mailing Address - Country:US
Mailing Address - Phone:503-569-4584
Mailing Address - Fax:
Practice Address - Street 1:220 JUDSON ST S
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-5309
Practice Address - Country:US
Practice Address - Phone:503-569-4584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR30848231H00000X, 235Z00000X
ORHAS-P-393752237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist