Individual
MS. STEFANIE MARIE MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
540 S MAIN ST, MOUNT ANGEL, OR 97362-9540
(503) 949-6963
Mailing address
4998 13TH AVE NE, KEIZER, OR 97303-3816
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/06/2017
Last updated
07/06/2017
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