Mallory Mackie Pllc | |
2701 Sylvan Dr W University Place WA 98466-2740 | |
(253) 241-2287 | |
Not Available |
Full Name | Mallory Mackie Pllc |
---|---|
Speciality | Social Worker |
Location | 2701 Sylvan Dr W, University Place, Washington |
Authorized Official Name and Position | Mallory Mackie (OWNER) |
Authorized Official Contact | 2532412287 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Mallory Mackie Pllc 2701 Sylvan Dr W University Place WA 98466-2740 Ph: (253) 241-2287 | Mallory Mackie Pllc 2701 Sylvan Dr W University Place WA 98466-2740 Ph: (253) 241-2287 |
NPI Number | 1942921952 |
---|---|
Provider Enumeration Date | 09/07/2022 |
Last Update Date | 09/07/2022 |
Certification Date | 09/07/2022 |
Medicare PECOS PAC ID | 7214306349 |
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Medicare Enrollment ID | O20221213001631 |
Identifier | Type | State | Issuer |
---|---|---|---|
1942921952 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Mallory Marie Mackie |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1114426764 PECOS PAC ID: 8123497252 Enrollment ID: I20221213001666 |
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