Healthcare Provider Details

I. General information

NPI: 1093653859
Provider Name (Legal Business Name): MACKENZIE BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32846 7TH CT SW
FEDERAL WAY WA
98023-5227
US

IV. Provider business mailing address

32846 7TH CT SW
FEDERAL WAY WA
98023-5227
US

V. Phone/Fax

Practice location:
  • Phone: 253-341-5135
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberA-3622193
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: