Provider Demographics
NPI:1457695470
Name:FINAN, CASSIE ROSEANNE
Entity Type:Individual
Prefix:MRS
First Name:CASSIE
Middle Name:ROSEANNE
Last Name:FINAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CASSIE
Other - Middle Name:ROSEANNE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 E FREMONT ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-2336
Mailing Address - Country:US
Mailing Address - Phone:350-804-3256
Mailing Address - Fax:360-804-2569
Practice Address - Street 1:200 E FREMONT ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-2336
Practice Address - Country:US
Practice Address - Phone:350-804-3256
Practice Address - Fax:360-804-2569
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60119323235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist