Russell, Mackenzie
Russell, Mackenzie is an individual health care provider with primary practice located at 304 Ne Hood Ave , Gresham OR 97030-7450. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Russell, Mackenzie can be contacted via phone (503) 666-1333.Contact Information
Primary practice address
304 Ne Hood Ave
Gresham OR 97030-7450
Phone: (503) 666-1333
Fax: (503) 666-2444
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 016695 | Oregon |
Profile Details
| NPI number | 1215554472 |
|---|---|
| LBN Legal business name | Russell, Mackenzie |
| Credentials | SLP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 2nd, 2020 |
| Last updated | Jul 2nd, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215554472 | NPPES |
| Oregon | Other | 016695 | SPEECH AND LANGUAGE PATHOLOGY BOARD |
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