| Doctor Name: | FEARECIA MADDOX |
| NPI Number: | 1710329107 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMP |
| License Number: | MA60351855 |
| Business Practice Address: | 12727 W 14th Ave Airway Heights, WA - 990019409 |
| Business Phone Number: | 5092444818 |
| Business Fax Number: | 5092448945 |
| Mailing Address: | 12721 E Shannon Ave, #c143 SPOKANE VALLEY |
| State: | WA |
| Postal Code: | 992161651 |
| Phone Number: | 2082907704 |
| Fax Number: | |
| NPI Enumeration Date: | 07/25/2013 |
| NPI Last Update Date: | 07/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225700000X |
| License Number: | MA60351855 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Massage Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |