Individual
MRS. MCKENZIE MICHELLE KEITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDP
Contact information
Practice address
5712 N LOMA DR, SPOKANE, WA 99205-7269
(928) 499-5954
Mailing address
5712 N LOMA DR, SPOKANE, WA 99205-7269
(928) 499-5954
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP61413299
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP61413299
DOH
WA
Enumeration date
09/21/2022
Last updated
07/07/2023
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