Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 70736-20 | WI |
NPI | 1003341819 |
---|---|
Provider Name | Sarah Elizabeth Mackay |
First Address | Wenatchee, WA 98801-2800 |
Second Address | Madison, WI 53705-2130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2017 |
Last Update Date | 06/10/2021 |