BETHE ANN MACK

PORTLAND, OR
NPI1033236922
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy302R00000X Health Maintenance Organization
(Licence: OR  11341)
Enumeration Date2007-03-23
Last Update Date2007-07-08
Business Address
Ms. BETHE ANN MACK LMT
2625 SE HAWTHORNE BLVD
PORTLAND, OR 97214-2941
Phone number: 503-238-9788
Mailing Address
Ms. BETHE ANN MACK LMT
4428 NE 74TH AVE
PORTLAND, OR 97218
Phone number: 503-481-4435
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