Individual
MADELINE WOOD ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
21980 N 83RD AVE, PEORIA, AZ 85383-1850
(623) 465-6375
Mailing address
21980 N 83RD AVE, PEORIA, AZ 85383-1850
(623) 465-6375
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
8497
AZ
363AM0700X
Medical Physician Assistant
PA61306757
WA
Other
Enumeration date
04/10/2021
Last updated
04/29/2025
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