Healthcare Provider Details

I. General information

NPI: 1730839937
Provider Name (Legal Business Name): RIGOBERTO MADRIGAL BS, AAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 03/28/2022
Certification Date: 03/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13343 NE BEL RED RD
BELLEVUE WA
98005-2274
US

IV. Provider business mailing address

18930 BOTHELL EVERETT HWY APT F103
BOTHELL WA
98012-5208
US

V. Phone/Fax

Practice location:
  • Phone: 206-461-4880
  • Fax:
Mailing address:
  • Phone: 360-441-2541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: