Individual
STACEY ANN MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
325 9TH AVE, SEATTLE, WA 98104-2420
(253) 697-5242
Mailing address
325 9TH AVE, SEATTLE, WA 98104-2420
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL60316452
WA
Other
Enumeration date
11/21/2014
Last updated
05/03/2024
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