Individual
DR. MATTHEW WILLIAM MACKINNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-0000
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
042.0040136
VT
2084P0800X
Psychiatry Physician
MD60762101
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780071415
—
WA
Enumeration date
04/21/2015
Last updated
05/13/2026
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