Individual
MR. SEAN PATRICK MACKIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4011 TALBOT RD S, SUITE 300, RENTON, WA 98055-5773
(425) 656-5060
(425) 656-5047
Mailing address
4011 TALBOT RD S, SUITE 300, RENTON, WA 98055-5773
(425) 656-5060
(425) 656-5047
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA 60056491
WA
363AS0400X
Surgical Physician Assistant
Primary
PA60056491
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0243716
L&I
WA
05
—
8538928
—
WA
Enumeration date
11/28/2008
Last updated
06/29/2016
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