Healthcare Provider Details

I. General information

NPI: 1467643882
Provider Name (Legal Business Name): JAYMIE FELICE MACKLER N.D., L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2007
Last Update Date: 06/28/2023
Certification Date: 06/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 E 17TH ST
VANCOUVER WA
98663-3428
US

IV. Provider business mailing address

2114 MAIN STREET #100, BOX 234
VANCOUVER WA
98660
US

V. Phone/Fax

Practice location:
  • Phone: 360-326-6336
  • Fax: 844-965-9804
Mailing address:
  • Phone: 360-326-6336
  • Fax: 844-965-9804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT00001411
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC00002759
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: