Provider Demographics
NPI:1750690020
Name:COSAND, AMANDA ROSE (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:ROSE
Last Name:COSAND
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:MISS
Other - First Name:AMANDA
Other - Middle Name:ROSE
Other - Last Name:OSWALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22606 196TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-0435
Mailing Address - Country:US
Mailing Address - Phone:509-998-3130
Mailing Address - Fax:
Practice Address - Street 1:22606 196TH AVE SE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98058-0435
Practice Address - Country:US
Practice Address - Phone:509-998-3130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-04
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASI60179514235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist