Organization
FUNCTIONAL MENTAL HEALTH LLC
Active
Other names
Functional Mental Health LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MCKENZIE SMITH (PMHNP)
(541) 326-8078
Entity
Organization
Contact information
Practice address
11 SW BRANTLEY DR, WINSTON, OR 97496-4526
(541) 679-0366
(541) 679-4821
Mailing address
11 SW BRANTLEY DR, WINSTON, OR 97496-4526
(541) 679-0366
(541) 679-4821
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/20/2020
Last updated
01/27/2021
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