Individual
DR. JOHN DEWOLFE MACKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19020 33RD AVE W STE 210, LYNNWOOD, WA 98036
(425) 563-1500
(425) 563-1501
Mailing address
19020 33RD AVE W STE 210, LYNNWOOD, WA 98036-4748
(425) 563-1500
(425) 563-1374
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
A99500
CA
2085P0229X
Pediatric Radiology Physician
Primary
MD60942783
WA
2085R0202X
Diagnostic Radiology Physician
A99500
CA
2085R0202X
Diagnostic Radiology Physician
MD60942783
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0408810
L&I-RADIA REST OF WA
WA
01
—
0408811
L&I-RADIA KING COUNTY
WA
01
—
0408812
L&I-SWEDISH RADIA EDMONDS
WA
01
—
0408813
L&I-EVERGREEN RADIA
WA
01
—
0408816
L&I-SOUTH SOUND RADIOLOGY
WA
01
—
0408817
L&I-SEATTLE RADIOLOGY
WA
05
—
1091767
—
WA
Enumeration date
06/27/2007
Last updated
08/22/2019
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