Provider Demographics
NPI:1992756555
Name:MADRONE, ANAPURNA (LMT)
Entity type:Individual
Prefix:
First Name:ANAPURNA
Middle Name:
Last Name:MADRONE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:
Other - Last Name:MADRONE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:7723 CENTER BLVD SE
Mailing Address - Street 2:
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-8930
Mailing Address - Country:US
Mailing Address - Phone:425-396-7778
Mailing Address - Fax:425-396-7097
Practice Address - Street 1:7723 CENTER BLVD SE
Practice Address - Street 2:
Practice Address - City:SNOQUALMIE
Practice Address - State:WA
Practice Address - Zip Code:98065-8930
Practice Address - Country:US
Practice Address - Phone:425-396-7778
Practice Address - Fax:425-396-7097
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00007564174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA00007564OtherMASSAGE THERAPIST