Provider Demographics
NPI:1568652089
Name:MADISON, JOYCE (SLP)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:MADISON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18120 97TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-3324
Mailing Address - Country:US
Mailing Address - Phone:425-481-1933
Mailing Address - Fax:425-481-9371
Practice Address - Street 1:18120 97TH AVE NE
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-3324
Practice Address - Country:US
Practice Address - Phone:425-481-1933
Practice Address - Fax:425-481-9371
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00004467235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist