NPI 1033236922

Bethe Ann Mack, LMT

Practitioner Health Maintenance Organization Portland, OR

Practice location

Address: 2625 SE Hawthorne Blvd, Portland, OR 97214-2941
Phone: (503) 238-9788
Mailing address: 4428 NE 74th Ave, Portland, OR 97218

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence 11341 (OR)

Other Health Maintenance Organization providers in Oregon →

Registry record

NPI: 1033236922
Entity type: Individual
Sex (as registered): Female
NPI issued: 23 Mar 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.