Provider Demographics
NPI:1871275982
Name:WESTRICH, MADISON MACKENZIE (PT, DPT)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:MACKENZIE
Last Name:WESTRICH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:MADISON
Other - Middle Name:MACKENZIE
Other - Last Name:KRAMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:3765 E BLUE LUPINE DR STE E
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-8417
Mailing Address - Country:US
Mailing Address - Phone:907-332-0021
Mailing Address - Fax:907-373-9464
Practice Address - Street 1:7985 E 16TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-2896
Practice Address - Country:US
Practice Address - Phone:907-332-0021
Practice Address - Fax:907-373-9464
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN13107225100000X
AK238419225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist