Individual
MACIE KATHRYN ZACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTRL
Contact information
Practice address
1101 E DIVISION ST, MOUNT VERNON, WA 98274-4004
(360) 899-4905
Mailing address
2900 GRAND AVE APT 642, EVERETT, WA 98201-4898
(616) 430-1651
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
5201013663
MI
225X00000X
Occupational Therapist
Primary
61555390
WA
Other
Enumeration date
07/11/2024
Last updated
07/11/2024
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