Individual
MRS. MADELAINE CATHLEEN MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8419 KERBAUGH RD NE, OLYMPIA, WA 98516-9349
(303) 359-1730
Mailing address
17950 PRESTON RD, STE 250, DALLAS, TX 75252-5793
(972) 354-5720
(972) 354-5747
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
61169119
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
25954555
—
CO
Enumeration date
06/10/2006
Last updated
09/04/2023
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