Individual
MADISON SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6400 MACARTHUR BLVD UNIT 7533, VANCOUVER, WA 98661-7533
(360) 313-2391
Mailing address
4506 NE 114TH ST, VANCOUVER, WA 98686-4444
(360) 606-1557
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
61581809
WA
Other
Enumeration date
10/10/2024
Last updated
10/10/2024
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