Provider Demographics
NPI:1538407747
Name:FRANCO, MADDIE RAE (MADDIE FRANCO)
Entity type:Individual
Prefix:
First Name:MADDIE
Middle Name:RAE
Last Name:FRANCO
Suffix:
Gender:F
Credentials:MADDIE FRANCO
Other - Prefix:
Other - First Name:MADELINE
Other - Middle Name:RAE
Other - Last Name:FRANCO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MADDIE FRANCO
Mailing Address - Street 1:4028 S PINE ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-5612
Mailing Address - Country:US
Mailing Address - Phone:253-225-6221
Mailing Address - Fax:
Practice Address - Street 1:4028 S PINE ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-5612
Practice Address - Country:US
Practice Address - Phone:253-225-6221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60315754225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist