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Individual

MCKENZIE HULL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
19250 SW 65TH AVE STE 125, TUALATIN, OR 97062
(503) 413-4505
(503) 413-4719
Mailing address
1650 NW NAITO PKWY STE 185, PORTLAND, OR 97209-2535
(971) 983-5260
(971) 983-5326

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056011253
IL
225X00000X
Occupational Therapist
Primary
349715
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500760019
OR
Enumeration date
10/22/2015
Last updated
04/02/2019
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