MACKENZIE EILEEN CALLIS APRN PMHNP NPI 1134895642

NPI Information

  • NPI: 1134895642
  • Provider Name: MACKENZIE EILEEN CALLIS, APRN, PMHNP
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • Address: 18650 SW BOONES FERRY RD STE 3
    TUALATIN, OR
    ZIP 97062
  • Phone: (503) 351-5858

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NPI Details

Mackenzie Eileen Callis, APRN, PMHNP is a psychiatric/mental health nurse practitioner in Tualatin, OR. Mackenzie Eileen Callis, APRN, PMHNP NPI is 1134895642. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

18650 SW BOONES FERRY RD STE 3
TUALATIN, OR
ZIP 97062-491
Phone: (503) 351-5858

The enumeration date for this NPI number is 8/17/2021 and was last updated on 9/12/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental Health180541ALASKANo
2363LP0808XNurse PractitionerPsychiatric/Mental Health202107871NP-PPOREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11724666MEDICAIDALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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