Healthcare Provider Details

I. General information

NPI: 1134920143
Provider Name (Legal Business Name): MACKENZI OSWALD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MACKENZI CHAPMAN

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 N 115TH ST
SEATTLE WA
98133-8401
US

IV. Provider business mailing address

1550 N 115TH ST # 358828
SEATTLE WA
98133-8401
US

V. Phone/Fax

Practice location:
  • Phone: 877-694-4677
  • Fax:
Mailing address:
  • Phone: 206-543-6577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: