Individual
MADELEINE REBECCA MCBROOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3600 LIND AVE SW STE 160, RENTON, WA 98057-4934
(425) 690-3513
(425) 690-9513
Mailing address
3600 LIND AVE SW, SUITE 100 - ATTN CREDENTIALING, RENTON, WA 98057-4970
(425) 228-3440
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT60928551
WA
225X00000X
Occupational Therapist
TL60928552
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2121595
—
WA
Enumeration date
02/06/2019
Last updated
05/02/2022
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