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General NPI Number Information
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NPI Number | 1093443509
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Entity Type | Individual
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Provider Name | MADISON ANN PARKS MA, LMFTA
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Gender | Female
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Dates
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Enumeration Date | 08/11/2022
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 13606 NE 20TH ST
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City | BELLEVUE
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State | WA
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Zip | 98005-2146
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Country | US
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Telephone | 425-610-6586
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2704
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City | REDMOND
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State | WA
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Zip | 98073-2704
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Country | US
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Telephone | 425-610-6586
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MG61475760
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License Number State | WA
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