Healthcare Provider Details

I. General information

NPI: 1538554357
Provider Name (Legal Business Name): HAYLEY JANE MACKINNON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2015
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST. BOX 356460 UNIVERSITY OF WASHINGTON DEPARTMENT OF OBGYN
SEATTLE WA
98109
US

IV. Provider business mailing address

PO BOX 50095
SEATTLE WA
98145-5095
US

V. Phone/Fax

Practice location:
  • Phone: 206-744-2250
  • Fax: 206-744-6312
Mailing address:
  • Phone: 206-520-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberMD60943689
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD60943689
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: