Provider Demographics
NPI:1053832196
Name:TROWBRIDGE, MADISON (MED, LBA, BCBA)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:TROWBRIDGE
Suffix:
Gender:F
Credentials:MED, LBA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6050 6TH AVE NW APT 5
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-2128
Mailing Address - Country:US
Mailing Address - Phone:503-358-0216
Mailing Address - Fax:
Practice Address - Street 1:3250 AIRPORT WAY S STE 542
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98134-2111
Practice Address - Country:US
Practice Address - Phone:206-580-6940
Practice Address - Fax:253-944-9062
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA11935578103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst