Provider Demographics
NPI:1508290156
Name:MCFADDEN, ROSE DOMINIQUE (SLP)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:DOMINIQUE
Last Name:MCFADDEN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1039B S CLOVERDALE ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-4744
Mailing Address - Country:US
Mailing Address - Phone:316-640-8165
Mailing Address - Fax:
Practice Address - Street 1:7445 SE 24TH ST
Practice Address - Street 2:
Practice Address - City:MERCER ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98040-2344
Practice Address - Country:US
Practice Address - Phone:206-279-5310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist