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NPI Code Detail

MEDICARE: MERILEE MACKAY LPN

MEDICARE: MERILEE MACKAY LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical NurseLP60278975WA

General Provider Information

NPI Number : 1619749454
Entity Type Code : Individual
Provider Name (Legal Business Name) : MERILEE MACKAY LPN
Provider Business Mailing Address
First Line : 33811 9TH AVE S
Second Line :
City : FEDERAL WAY
State : WA
Zip : 98003-6707
Country : US
Telephone Number : 253-350-0882
Fax Number :
Provider Business Practice Location Address
First Line : 4411 BROWNS POINT BLVD
Second Line :
City : TACOMA
State : WA
Zip : 98422-2041
Country : US
Telephone Number : 253-925-9220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2023
Last Update Date : 10/25/2023

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Directions to “ MERILEE MACKAY LPN” Practice Location

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