Callis, Mackenzie Eileen
Callis, Mackenzie Eileen is an individual health care provider with primary practice located at 18650 Sw Boones Ferry Rd Ste 3 , Tualatin OR 97062-8491. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Callis, Mackenzie Eileen can be contacted via phone (503) 351-5858.Contact Information
Primary practice address
18650 Sw Boones Ferry Rd Ste 3
Tualatin OR 97062-8491
Phone: (503) 351-5858
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 180541 | Alaska |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 202107871NP-PP | Oregon |
Profile Details
| NPI number | 1134895642 |
|---|---|
| LBN Legal business name | Callis, Mackenzie Eileen |
| Credentials | APRN, PMHNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 17th, 2021 |
| Last updated | Sep 12th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134895642 | NPPES |
| Alaska | MEDICAID | 1724666 |
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