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Individual

MACKENZIE ANNE CHAMP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
N.D., LA.C

Contact information

Practice address
35890 HIGHWAY 101 N, NEHALEM, OR 97131-9599
(503) 368-4312
(503) 368-4315
Mailing address
PO BOX 504, NEHALEM, OR 97131-0504
(503) 368-4312
(503) 368-4315

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
156719
OR
173C00000X
Reflexologist
14010
OR
175F00000X
Naturopath
Primary
2005
OR

Other

Enumeration date
09/18/2013
Last updated
01/23/2015
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