Organization
MACKIE WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH MACKIE (PRESIDENT)
(458) 230-5248
Entity
Organization
Contact information
Practice address
701 N 5TH ST, LEBANON, OR 97355-9559
(458) 230-5248
Mailing address
701 N 5TH ST, LEBANON, OR 97355-9559
(458) 230-5248
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/04/2021
Last updated
05/04/2021
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