Provider Demographics
NPI:1881845956
Name:MADSEN, ANDREW P (MS, CFY)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:P
Last Name:MADSEN
Suffix:
Gender:M
Credentials:MS, CFY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14049 6TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98168-3522
Mailing Address - Country:US
Mailing Address - Phone:425-556-6318
Mailing Address - Fax:
Practice Address - Street 1:626 120TH AVE NE
Practice Address - Street 2:# B201
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-3077
Practice Address - Country:US
Practice Address - Phone:425-556-6318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASI60049283235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist