| Mackie Wellness Llc | |
|
701 N 5th St Lebanon OR 97355-9559 | |
| (458) 230-5248 | |
| Not Available |
| Full Name | Mackie Wellness Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 701 N 5th St, Lebanon, Oregon |
| Authorized Official Name and Position | Kenneth Mackie (PRESIDENT) |
| Authorized Official Contact | 4582305248 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mackie Wellness Llc 701 N 5th St Lebanon OR 97355-9559 Ph: (458) 230-5248 | Mackie Wellness Llc 701 N 5th St Lebanon OR 97355-9559 Ph: (458) 230-5248 |
| NPI Number | 1124601448 |
|---|---|
| Provider Enumeration Date | 05/04/2021 |
| Last Update Date | 05/04/2021 |
| Certification Date | 05/04/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124601448 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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