Provider Demographics
NPI:1033981584
Name:GUIZAR, MADELINE MARIE
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:MARIE
Last Name:GUIZAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11318 NE 67TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-7126
Mailing Address - Country:US
Mailing Address - Phone:810-887-7448
Mailing Address - Fax:
Practice Address - Street 1:15446 BEL RED RD STE 200
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-5517
Practice Address - Country:US
Practice Address - Phone:425-295-7697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health