Provider Demographics
NPI:1871025577
Name:HAYS, MACKENZIE (LMT)
Entity Type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:
Last Name:HAYS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10001 SE SUNNYSIDE RD
Mailing Address - Street 2:STE 220
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-5746
Mailing Address - Country:US
Mailing Address - Phone:503-908-0881
Mailing Address - Fax:503-908-0891
Practice Address - Street 1:10001 SE SUNNYSIDE RD
Practice Address - Street 2:STE 220
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-5746
Practice Address - Country:US
Practice Address - Phone:503-908-0881
Practice Address - Fax:503-908-0891
Is Sole Proprietor?:No
Enumeration Date:2017-03-31
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15770225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist