Basic Information
| Provider Information | |||||||||
| NPI: | 1730839937 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MADRIGAL | ||||||||
| FirstName: | RIGOBERTO | ||||||||
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| Credential: | BS, AAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18930 BOTHELL EVERETT HWY APT F103 | ||||||||
| Address2: | |||||||||
| City: | BOTHELL | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980125208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604412541 | ||||||||
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| Practice Location | |||||||||
| Address1: | 13343 NE BEL RED RD | ||||||||
| Address2: | |||||||||
| City: | BELLEVUE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980052274 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2064614880 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2022 | ||||||||
| LastUpdateDate: | 03/28/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | WA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.