Mackenzy Killian Mingal

NPI #1497396360 in Beaverton, Oregon

Provider Information

NPI Number: 1497396360
Entity Type: Individual
Name: Mackenzy Killian Mingal
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Oct 2, 2019
Last Updated: Oct 2, 2019

Practice Location

Address: 1800 NW 169TH PL STE B100
City: Beaverton
State: Oregon
ZIP Code: 97006-7362
Phone: (503) 350-7050

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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