Provider Demographics
NPI:1487376943
Name:TWADDELL, MACKENZIE (OTD)
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:
Last Name:TWADDELL
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 1ST AVE APT N409
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-1040
Mailing Address - Country:US
Mailing Address - Phone:717-919-4351
Mailing Address - Fax:
Practice Address - Street 1:2900 1ST AVE APT N409
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-1040
Practice Address - Country:US
Practice Address - Phone:717-919-4351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist