Individual
BRIAN LEE MCKENZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
QMHA
Contact information
Practice address
2415 SE 42ND, PORTLAND, OR 97206
(503) 872-0144
Mailing address
7680 SW 74TH AVE, APT. 6, PORTLAND, OR 97223-9595
(503) 547-4991
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/30/2007
Last updated
10/19/2007
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