Provider Demographics
NPI:1427828714
Name:MAXON, MARGARET (MHCAMC61454669)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:
Last Name:MAXON
Suffix:
Gender:F
Credentials:MHCAMC61454669
Other - Prefix:MS
Other - First Name:MARGO
Other - Middle Name:
Other - Last Name:MAXON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MHCAMC61454669
Mailing Address - Street 1:4252 245TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98029-7548
Mailing Address - Country:US
Mailing Address - Phone:425-281-8736
Mailing Address - Fax:
Practice Address - Street 1:1601 116TH AVE NE STE 102&111
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3010
Practice Address - Country:US
Practice Address - Phone:425-947-5030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMHCA.MC.61454669101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health