Mack, Annie Seapan

Mack, Annie Seapan is an individual health care provider with primary practice located at 9555 Sw Barnes Rd Ste 255 , Portland OR 97225-6654. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Mack, Annie Seapan can be contacted via phone (503) 908-1590.

Contact Information

Primary practice address
9555 Sw Barnes Rd Ste 255 Portland OR 97225-6654
Phone: (503) 908-1590
Fax: (503) 723-2862
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD27041 Oregon
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD27041 Oregon

Profile Details

NPI number 1932125184
LBN Legal business name Mack, Annie Seapan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2006
Last updated Apr 3rd, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932125184 NPPES
Oregon MEDICAID 500633407

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