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NPI Code Detail

MEDICARE: MS. SUZETTE FLORENCE MADSON PT

MEDICARE: MS. SUZETTE FLORENCE MADSON PT
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
1225100000XPhysical Therapist025208 PT00006112WA
2225100000XPhysical Therapist032698NY
32251S0007XSports Physical Therapist025208 PT00006112WA
42251S0007XSports Physical Therapist032698NY
52251X0800XOrthopedic Physical Therapist032698NY
62251X0800XOrthopedic Physical Therapist025208 PT00006112WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1112243OTHERWALABOR AND INDUSTRIES
2MA0471OTHERWAREGENCE BLUE SHIELD

General Provider Information

NPI Number : 1902969678
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUZETTE FLORENCE MADSON PT
Provider Business Mailing Address
First Line : PO BOX 6175
Second Line :
City : BELLEVUE
State : WA
Zip : 98008-0175
Country : US
Telephone Number : 425-643-0373
Fax Number : 425-747-6367
Provider Business Practice Location Address
First Line : 634 7TH AVE OFC 6
Second Line :
City : KIRKLAND
State : WA
Zip : 98033-5665
Country : US
Telephone Number : 425-542-3306
Fax Number : 425-747-6367
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2006
Last Update Date : 01/01/2025

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