Provider Demographics
NPI:1093362493
Name:PEYTON, MACKENZIE SUE (MSW)
Entity Type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:SUE
Last Name:PEYTON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1216 PINE ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1959
Mailing Address - Country:US
Mailing Address - Phone:176-820-6323
Mailing Address - Fax:
Practice Address - Street 1:1216 PINE ST STE 300
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1959
Practice Address - Country:US
Practice Address - Phone:176-820-6323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical