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General NPI Number Information
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NPI Number | 1205703063
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Entity Type | Organization
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Legal Business Name | MADRONA THERAPY GROUP, P.C.
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Dates
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Enumeration Date | 10/17/2025
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 1622 3RD ST
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City | MARYSVILLE
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State | WA
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Zip | 98270-5004
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Country | US
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Telephone | 678-763-8146
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Fax |
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Provider Business Mailing Address
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Address Line | 138 AVENIDA SIERRA
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City | SAN CLEMENTE
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State | CA
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Zip | 92672-3823
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Country | US
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Telephone | 678-763-8146
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CONNER CRESS
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Credential | LMHC, LPCC
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Telephone | 678-763-8146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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