Provider Demographics
NPI:1982940250
Name:EADIE, KAREN ROSE (WA STATE SLP LICENSE)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ROSE
Last Name:EADIE
Suffix:
Gender:F
Credentials:WA STATE SLP LICENSE
Other - Prefix:MISS
Other - First Name:KAREN
Other - Middle Name:ROSE
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP FROM ASHA
Mailing Address - Street 1:112 ELLIOTT AVE S
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2500
Mailing Address - Country:US
Mailing Address - Phone:509-663-7117
Mailing Address - Fax:509-662-9227
Practice Address - Street 1:112 ELLIOTT AVE S
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2500
Practice Address - Country:US
Practice Address - Phone:509-663-7117
Practice Address - Fax:509-662-9227
Is Sole Proprietor?:No
Enumeration Date:2012-12-14
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL 00001596235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist