Healthcare Provider Details

I. General information

NPI: 1952081945
Provider Name (Legal Business Name): MADELEINE M STELTZ MS, LAT, ATC, OPE-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 W 5TH AVE
SPOKANE WA
99204-2901
US

IV. Provider business mailing address

911 W 5TH AVE
SPOKANE WA
99204-2901
US

V. Phone/Fax

Practice location:
  • Phone: 844-220-9885
  • Fax:
Mailing address:
  • Phone: 425-551-8760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberATHL.A1.70028759
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: