Healthcare Provider Details

I. General information

NPI: 1881479764
Provider Name (Legal Business Name): ZOE MACKAY CSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2023
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18765 SW BOONES FERRY RD
TUALATIN OR
97062-8496
US

IV. Provider business mailing address

18765 SW BOONES FERRY RD
TUALATIN OR
97062-8496
US

V. Phone/Fax

Practice location:
  • Phone: 503-612-1000
  • Fax:
Mailing address:
  • Phone: 503-612-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberA15427
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: