Mrs Kelly Jene Mack, BS, CADCI is a
Case Manager/care Coordinator based in Salem, Oregon. Mrs Kelly Jene Mack is licensed to practice in * (Not Available) (license number ) and her current practice location is
3737 Portland Rd Ne, Salem, Oregon. She can be reached at her office (for appointments etc.) via phone at
(503) 390-2600.
NPI number for Mrs Kelly Jene Mack is 1164692455 and her current mailing address is 3737 Portland Rd Ne, Salem, Oregon. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1164692455.
Healthcare Provider's Profile
Full Name | Mrs Kelly Jene Mack |
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Gender | Female |
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Speciality | Case Manager/care Coordinator |
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Location | 3737 Portland Rd Ne, Salem, Oregon |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1164692455
- Provider Enumeration Date: 03/03/2008
- Last Update Date: 07/10/2019
Medical Identifiers
Medical identifiers for Mrs Kelly Jene Mack such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1164692455 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | 05-11-34 (Oregon) | Secondary |
171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Kelly Jene Mack is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Kelly Jene Mack, BS, CADCI 3737 Portland Rd Ne, Salem, OR 97301-0311 Ph: (503) 390-2600 | Mrs Kelly Jene Mack, BS, CADCI 3737 Portland Rd Ne, Salem, OR 97301-0311 Ph: (503) 390-2600 |
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