Most Relevant Information
Provider Data
| NPI Number: | 1003445636 |
| Provider Name: | MACKENZIE JEAN EIKAMP PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 0010-09843 |
Most Important Dates
| Enumeration Date: | 04/06/2020 |
| Last Updated: | 09/18/2024 |
Provider Practice Location
3181 SW SAM JACKSON PARK RD
PORTLAND
OR
972393011
Practice Location Phone/Fax
| Phone: | 5034941620 |
| Fax: | 5034946670 |
Provider Mailing Location
3181 SW SAM JACKSON PARK RD
PORTLAND
OR
972393011
Provider Mailing Phone/Fax
| Phone: | 5034941620 |
| Fax: | 5034946670 |