Individual
BADROSSADAT MADANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
14701 179TH AVE SE, MONROE, WA 98272-1108
(360) 863-4664
(360) 860-4663
Mailing address
14701 179TH AVE SE, MONROE, WA 98272-1108
(360) 863-4664
(360) 860-4663
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MD00030585
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8157729
—
WA
Enumeration date
01/31/2007
Last updated
07/08/2007
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