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MACKIE ENTERPRISES LLC NPI 1700396793


NPI Information

NPI: 1700396793
Provider Name: MACKIE ENTERPRISES LLC
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
1134 NE 70TH AVE
PORTLAND, OR
ZIP 97213
Phone: (971) 207-5010
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MACKIE ENTERPRISES LLC is a mental health counselor in Portland, OR. MACKIE ENTERPRISES LLC NPI is 1700396793. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1134 NE 70TH AVE
PORTLAND, OR
ZIP 97213-420
Phone: (971) 207-5010

The provider's authorized official is Keith John Mackie .
The authorized official title is Owner and has the following contact phone number (971) 207-5010.

The enumeration date for this NPI number is 10/4/2017 and was last updated on 2/8/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YA0400XCounselorAddiction (Substance Use Disorder)07-09-29OREGONNo
2101YM0800XCounselorMental HealthC2538OREGONYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1164936MEDICAIDOREGON

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.