Healthcare Provider Details

I. General information

NPI: 1700307741
Provider Name (Legal Business Name): MAKENZIE ANNE MUILENBURG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2017
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1037 NE 65TH ST # 346
SEATTLE WA
98115-6655
US

IV. Provider business mailing address

1037 NE 65TH ST # 346
SEATTLE WA
98115-6655
US

V. Phone/Fax

Practice location:
  • Phone: 206-451-7393
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: