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General NPI Number Information
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NPI Number | 1033928585
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Entity Type | Individual
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Provider Name | MADISON CLAIRE PLUMMER LCPO
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Gender | Female
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Dates
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Enumeration Date | 12/30/2024
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 208 LILLY RD NE STE A
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City | OLYMPIA
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State | WA
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Zip | 98506-6100
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Country | US
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Telephone | 360-338-0284
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Fax |
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Provider Business Mailing Address
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Address Line | 4118 ROSEDALE ST
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City | GIG HARBOR
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State | WA
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Zip | 98335-1830
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number | PS61362097
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 222Z00000X
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Taxonomy Name | Orthotist
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License Number | OI61337445
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License Number State | WA
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