Individual
MACKENZIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(425) 749-9723
Mailing address
PO BOX 944, LOPEZ ISLAND, WA 98261-0944
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
13601045-3102
UT
Other
Enumeration date
04/13/2026
Last updated
04/13/2026
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