Individual
MACKENZIE SCHACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3320 SE HOLGATE BLVD, PORTLAND, OR 97202-3459
(503) 231-1411
(503) 239-1170
Mailing address
3320 SE HOLGATE BLVD, PORTLAND, OR 97202-3459
(503) 231-1411
(503) 239-1170
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
296675
OR
Other
Enumeration date
01/30/2014
Last updated
01/30/2014
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