Individual
KELLI MACKAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
722 NE 162ND AVE, PORTLAND, OR 97230-5760
(503) 262-0145
Mailing address
9830 NE CASCADES PKWY, STE 200, PORTLAND, OR 97220-6832
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
02/08/2017
Last updated
02/08/2017
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