Healthcare Provider Details

I. General information

NPI: 1952334567
Provider Name (Legal Business Name): PRISCILLA M MADSEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 04/27/2021
Certification Date: 04/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 16TH AVE E
SEATTLE WA
98112-5226
US

IV. Provider business mailing address

201 16TH AVE E
SEATTLE WA
98112-5226
US

V. Phone/Fax

Practice location:
  • Phone: 206-326-3000
  • Fax:
Mailing address:
  • Phone: 206-326-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberMD00047165
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA78930
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA78930
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: