Provider Demographics
NPI:1770023228
Name:MCFADDEN, TENESHA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:TENESHA
Middle Name:
Last Name:MCFADDEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 23RD AVE
Mailing Address - Street 2:APARTMENT E412
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2989
Mailing Address - Country:US
Mailing Address - Phone:253-973-8200
Mailing Address - Fax:
Practice Address - Street 1:4311 11TH AVE NE
Practice Address - Street 2:SUITE 200
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-6366
Practice Address - Country:US
Practice Address - Phone:296-616-4001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-02
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56215363A00000X
WAPA61139272363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant