Mackinnon, Philip N

Mackinnon, Philip N is an individual health care provider with primary practice located at 415 6Th St , Lewiston ID 83501-2431. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Mackinnon, Philip N can be contacted via phone (208) 743-2511.

Contact Information

Primary practice address
415 6Th St Lewiston ID 83501-2431
Phone: (208) 743-2511
Fax: (208) 799-5554
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PSY235 Washington

Profile Details

NPI number 1376681098
LBN Legal business name Mackinnon, Philip N
Credentials PH D
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2007
Last updated Jul 9th, 2007 - about 18 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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Identifiers

StateTypeNumberIssuer
All States NPI 1376681098 NPPES
Washington MEDICAID 8373920
Washington Other N5905
Washington Other 0215850
Washington Other 10016370

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