Provider Demographics
NPI:1740420736
Name:MCQUADE, DAVID PAUL (LMP)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:PAUL
Last Name:MCQUADE
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 UNION AVE SE UNIT 117
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98059-5171
Mailing Address - Country:US
Mailing Address - Phone:206-334-0536
Mailing Address - Fax:
Practice Address - Street 1:32015 1ST AVE S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-5701
Practice Address - Country:US
Practice Address - Phone:253-927-9382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2009-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00022592225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist