Individual
MR. LEUSO MCKENZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 NE IRVING ST, SUITE 250, PORTLAND, OR 97232-2243
(503) 258-4200
Mailing address
13818 NE 62ND ST, VANCOUVER, WA 98682-5952
(206) 393-8404
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
01/16/2010
Last updated
01/16/2010
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