Individual
MACKIE MARINELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14645 SW FARMINGTON RD, BEAVERTON, OR 97007-2727
(541) 207-7523
Mailing address
1740 NW ARTHUR CIR, CORVALLIS, OR 97330-1941
(541) 207-7523
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
T09200
OR
Other
Enumeration date
07/01/2015
Last updated
07/01/2015
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