Provider Demographics
NPI:1962753160
Name:SLUDER, DARLENE CASH (LMP)
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:CASH
Last Name:SLUDER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13430 SE 200TH ST
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98042-3013
Mailing Address - Country:US
Mailing Address - Phone:206-919-9048
Mailing Address - Fax:
Practice Address - Street 1:13430 SE 200TH ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98042-3013
Practice Address - Country:US
Practice Address - Phone:206-919-9048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60298089225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist