Kelly, Mackenzie

Kelly, Mackenzie is an individual health care provider with primary practice located at 3181 Sw Sam Jackson Park Rd , Portland OR 97239-3098. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is her primary health care specialty. Kelly, Mackenzie can be contacted via phone (503) 494-8211.

Contact Information

Primary practice address
3181 Sw Sam Jackson Park Rd Portland OR 97239-3098
Phone: (503) 494-8211
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 125.073820 Illinois
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X PG198843 Oregon

Profile Details

NPI number 1942761580
LBN Legal business name Kelly, Mackenzie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2019
Last updated Jun 16th, 2020 - about 5 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.

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