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NPI Code Detail

MEDICARE: MADELINE KUDLATA

MEDICARE: MADELINE KUDLATA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist61624065WA

General Provider Information

NPI Number : 1760295919
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELINE KUDLATA
Provider Business Mailing Address
First Line : 348 NW 48TH ST
Second Line :
City : SEATTLE
State : WA
Zip : 98107-3539
Country : US
Telephone Number : 262-408-0471
Fax Number :
Provider Business Practice Location Address
First Line : 1100 NW 50TH ST
Second Line :
City : SEATTLE
State : WA
Zip : 98107-5119
Country : US
Telephone Number : 206-789-6288
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2025
Last Update Date : 01/30/2025

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Directions to “ MADELINE KUDLATA ” Practice Location

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