Provider Demographics
NPI:1043932742
Name:RACKERS, MADELEINE (MSW)
Entity Type:Individual
Prefix:
First Name:MADELEINE
Middle Name:
Last Name:RACKERS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:LENNOX
Other - Middle Name:
Other - Last Name:MARS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15315 1ST AVE NE, SUITE 216
Mailing Address - Street 2:PO BOX 816
Mailing Address - City:DUVALL
Mailing Address - State:WA
Mailing Address - Zip Code:98019
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15315 1ST AVE NE SUITE 216
Practice Address - Street 2:
Practice Address - City:DUVALL
Practice Address - State:WA
Practice Address - Zip Code:98019-5005
Practice Address - Country:US
Practice Address - Phone:425-780-6227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker