Individual
MISS MADELINE ELIZABETH FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
9020 BLAINE ST, JOINT BASE LEWIS MCCHORD, WA 98433-1219
(253) 583-5250
Mailing address
10903 GRAVELLY LAKE DR SW, LAKEWOOD, WA 98499-1341
(253) 583-5000
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC61248196
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000
N/A
WA
Enumeration date
02/22/2022
Last updated
02/22/2022
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