Individual
KRISTI ANN MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
54771 MCKENZIE HWY, BLUE RIVER, OR 97413-9790
(541) 234-3255
Mailing address
PO BOX 546, GRESHAM, OR 97030-0132
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
L13255
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500721884
—
OR
Enumeration date
10/18/2010
Last updated
11/18/2022
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