Individual
MCKENZIE HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2011 4TH ST, LA GRANDE, OR 97850-2511
(541) 962-7808
(541) 429-6661
Mailing address
PO BOX 1517, PENDLETON, OR 97801-0410
(877) 708-1119
(541) 278-8349
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
64324
ID
363LF0000X
Family Nurse Practitioner
Primary
10014371
OR
Other
Enumeration date
08/18/2023
Last updated
04/01/2026
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