Individual
MYKENZI DONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1002 LIBRARY CT, OREGON CITY, OR 97045-4066
(503) 655-8264
Mailing address
4837 NE COUCH ST, PORTLAND, OR 97213-2913
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/20/2022
Last updated
10/20/2022
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