Provider Demographics
NPI:1528043015
Name:SEELY-FADICH, AIMEE C
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:C
Last Name:SEELY-FADICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:C
Other - Last Name:SEELY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4101 APRIL DR
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-9069
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1556 N WENATCHEE AVE STE D
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-8405
Practice Address - Country:US
Practice Address - Phone:509-852-7000
Practice Address - Fax:509-852-7002
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD00002103231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA-2103OtherPROFESSIONAL LICENSE
WA1044574Medicaid
WAG8900006Medicare PIN