Individual
JENNIFER E MACKENZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC, NREMT-B
Contact information
Practice address
22450 19TH AVE S, DES MOINES, WA 98198-7623
(206) 631-7019
Mailing address
9220 NE BLUEFIN CT, BAINBRIDGE ISLAND, WA 98110-4603
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A160647869
WA
Other
Enumeration date
08/09/2017
Last updated
08/09/2017
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