Provider Demographics
NPI:1952037673
Name:NARD, MCKENNA ANDERSON (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MCKENNA
Middle Name:ANDERSON
Last Name:NARD
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 STONE WAY N APT 202
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8070
Mailing Address - Country:US
Mailing Address - Phone:184-771-6059
Mailing Address - Fax:
Practice Address - Street 1:35535 6TH PL SW
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-8109
Practice Address - Country:US
Practice Address - Phone:253-874-5445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL61327248235Z00000X
TX121489235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALL61327248OtherWA STATE SPEECH LANGUAGE PATHOLOGIST LICENSE
14360323OtherAMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION