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General NPI Number Information
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NPI Number | 1124797360
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Entity Type | Individual
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Provider Name | MADELYN NICOLE GOODROW
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Gender | Female
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Dates
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Enumeration Date | 09/10/2021
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 350 SE ANDREWS ST
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City | ISSAQUAH
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State | WA
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Zip | 98027-3413
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Country | US
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Telephone | 425-996-9528
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Fax | 425-336-3416
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Provider Business Mailing Address
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Address Line | 1800 41ST ST
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City | EVERETT
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State | WA
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Zip | 98203-2355
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Country | US
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Telephone | 425-259-3191
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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