Provider Demographics
NPI:1285912964
Name:PEADON, MICHELLE S (MA)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:S
Last Name:PEADON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32129 111TH CT SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-4712
Mailing Address - Country:US
Mailing Address - Phone:425-221-3582
Mailing Address - Fax:
Practice Address - Street 1:13210 SE 240TH ST STE A5
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98042-5182
Practice Address - Country:US
Practice Address - Phone:425-221-3582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-28
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor