MACKENZIE EILEEN CALLIS APRN PMHNP NPI 1134895642

NPI Information

NPI: 1134895642
Provider Name: MACKENZIE EILEEN CALLIS, APRN, PMHNP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

Address:
18650 SW BOONES FERRY RD STE 3
TUALATIN, OR
ZIP 97062
Phone: (503) 351-5858
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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 1/7/2022.

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
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	180541	ALASKA	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	202107871NP-PP	OREGON	Yes

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
1	1724666	MEDICAID	ALASKA

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: 11/14/2023

NPI Synchronization or Removal

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