Provider Demographics
NPI:1396875761
Name:SKY, MADRONE KARIN (LMT)
Entity type:Individual
Prefix:MRS
First Name:MADRONE
Middle Name:KARIN
Last Name:SKY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MRS
Other - First Name:MADRONE
Other - Middle Name:KARIN
Other - Last Name:FROHLICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:2366 EASTLAKE AVE
Mailing Address - Street 2:STE 330
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102
Mailing Address - Country:US
Mailing Address - Phone:203-353-2649
Mailing Address - Fax:203-567-4101
Practice Address - Street 1:2366 EASTLAKE AVE
Practice Address - Street 2:STE 330
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102
Practice Address - Country:US
Practice Address - Phone:203-353-2649
Practice Address - Fax:203-567-4101
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00009069225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist