Provider Demographics
NPI:1396145868
Name:MCFADDEN, CHEYANNE
Entity type:Individual
Prefix:
First Name:CHEYANNE
Middle Name:
Last Name:MCFADDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:MANSON
Mailing Address - State:WA
Mailing Address - Zip Code:98831-9699
Mailing Address - Country:US
Mailing Address - Phone:509-679-5556
Mailing Address - Fax:
Practice Address - Street 1:13701 E SPRAGUE AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-0811
Practice Address - Country:US
Practice Address - Phone:509-922-5585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-02
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60390679225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist