MEDICARE: MADISON ELZINGA

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1942132378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON ELZINGA

Provider Business Mailing Address
First Line	:	PO BOX 1360
Second Line	:
City	:	PHILOMATH
State	:	OR
Zip	:	97370-1360
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	629 HICKORY ST NW STE 160
Second Line	:
City	:	ALBANY
State	:	OR
Zip	:	97321-1778
Country	:	US
Telephone Number	:	541-730-4655
Fax Number	:

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

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “ MADISON ELZINGA ” Practice Location

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