Provider Demographics
NPI:1033906110
Name:MCQUEEN, MARY EILEEN (MPSS-HAPZSE)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:EILEEN
Last Name:MCQUEEN
Suffix:
Gender:
Credentials:MPSS-HAPZSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2212 S JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-2591
Mailing Address - Country:US
Mailing Address - Phone:206-322-2387
Mailing Address - Fax:206-324-4952
Practice Address - Street 1:1742 13TH AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-4112
Practice Address - Country:US
Practice Address - Phone:206-771-1910
Practice Address - Fax:206-324-4952
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMPSS-HAPZSE101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor