MEDICARE: MADISON GALLIANO LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1609527027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON GALLIANO LMHC

Provider Business Mailing Address
First Line	:	PO BOX 18741
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98118-0741
Country	:	US
Telephone Number	:	785-806-9708
Fax Number	:

Provider Business Practice Location Address
First Line	:	707 S SNOQUALMIE ST STE 5A
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98108-1742
Country	:	US
Telephone Number	:	785-806-9708
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2022
Last Update Date	:	03/10/2024

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