Provider Demographics
NPI:1396962585
Name:MORRISON, MADELEINE CARROLL (ND)
Entity type:Individual
Prefix:DR
First Name:MADELEINE
Middle Name:CARROLL
Last Name:MORRISON
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:COTATI
Mailing Address - State:CA
Mailing Address - Zip Code:94931-6105
Mailing Address - Country:US
Mailing Address - Phone:907-632-5632
Mailing Address - Fax:
Practice Address - Street 1:435 PETALUMA AVE STE 150
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-4273
Practice Address - Country:US
Practice Address - Phone:707-861-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK904401175F00000X
CA1365175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath