Provider Demographics
NPI:1205133162
Name:SADLER, MADORA M
Entity type:Individual
Prefix:
First Name:MADORA
Middle Name:M
Last Name:SADLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MADORA
Other - Middle Name:M
Other - Last Name:ALTHAUSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1104 ABOTT
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-7901
Mailing Address - Country:US
Mailing Address - Phone:509-543-8513
Mailing Address - Fax:
Practice Address - Street 1:515 W COURT ST
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-3737
Practice Address - Country:US
Practice Address - Phone:509-543-1902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-11
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60272512101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health