Provider Demographics
NPI:1104508175
Name:MADRIGAL, ZUZANA (MSW, LSWAIC)
Entity type:Individual
Prefix:
First Name:ZUZANA
Middle Name:
Last Name:MADRIGAL
Suffix:
Gender:F
Credentials:MSW, LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98930-1357
Mailing Address - Country:US
Mailing Address - Phone:509-882-4260
Mailing Address - Fax:
Practice Address - Street 1:240 DIVISION ST
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:WA
Practice Address - Zip Code:98930-1357
Practice Address - Country:US
Practice Address - Phone:509-882-4260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC61310605101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health