Provider Demographics
NPI:1639794381
Name:WILLIAMS, MADALYN ROSE (DPT)
Entity Type:Individual
Prefix:
First Name:MADALYN
Middle Name:ROSE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MADALYN
Other - Middle Name:ROSE
Other - Last Name:TUREK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9310 N DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1227
Mailing Address - Country:US
Mailing Address - Phone:509-789-2836
Mailing Address - Fax:509-789-2839
Practice Address - Street 1:9310 N DIVISION ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1227
Practice Address - Country:US
Practice Address - Phone:509-789-2836
Practice Address - Fax:509-789-2839
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT61039585225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist