Provider Demographics
NPI:1346431665
Name:MADOW, HOWARD SCOTT (IDC)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:SCOTT
Last Name:MADOW
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2411 84TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98205
Mailing Address - Country:US
Mailing Address - Phone:425-304-5188
Mailing Address - Fax:
Practice Address - Street 1:2411 84TH AVE NE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98205
Practice Address - Country:US
Practice Address - Phone:425-304-5188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other