Individual
MACKYLE COPLEY-SCITERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
530 NW 27TH ST, CORVALLIS, OR 97330-5223
(541) 766-6835
Mailing address
815 NW 11TH ST, CORVALLIS, OR 97330-6016
(503) 576-9714
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
05/05/2022
Last updated
05/05/2022
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