Provider Demographics
NPI:1285908327
Name:KANNADATH, DINESH (MSC)
Entity type:Individual
Prefix:
First Name:DINESH
Middle Name:
Last Name:KANNADATH
Suffix:
Gender:M
Credentials:MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1542 E LAKE SAMMAMISH PKWY NE
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98074-6639
Mailing Address - Country:US
Mailing Address - Phone:425-868-3669
Mailing Address - Fax:
Practice Address - Street 1:1542 E LAKE SAMMAMISH PKWY NE
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98074-6639
Practice Address - Country:US
Practice Address - Phone:425-868-3669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist