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General NPI Number Information
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NPI Number | 1780965681
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Entity Type | Individual
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Provider Name | KAMMI LYNN MADSEN LMP
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Gender | Female
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Dates
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Enumeration Date | 09/06/2011
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Last Update Date | 09/06/2011
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Provider Practice Location Address
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Address Line | 2032 148TH AVE NE
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City | REDMOND
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State | WA
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Zip | 98052-5527
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Country | US
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Telephone | 425-869-5808
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Fax | 425-283-5022
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Provider Business Mailing Address
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Address Line | 1203 JAMES ST APT 203
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City | SEATTLE
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State | WA
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Zip | 98104-2105
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Country | US
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Telephone | 509-263-4034
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA 60136712
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License Number State | WA
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