| Doctor Name: | ROSE ANN MEAD |
| NPI Number: | 1508104308 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CDP |
| License Number: | CP60076419 |
| Business Practice Address: | 934 S Garfield Rd Airway Heights, WA - 990019030 |
| Business Phone Number: | 5097897630 |
| Business Fax Number: | 5094450646 |
| Mailing Address: | Po Box 67, USK |
| State: | WA |
| Postal Code: | 991800067 |
| Phone Number: | 5097897630 |
| Fax Number: | 5094450646 |
| NPI Enumeration Date: | 01/29/2013 |
| NPI Last Update Date: | 01/29/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0405X |
| License Number: | CP60076419 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
| Taxonomy Definition: | |