Individual
ROBERTA LEE MCKENNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
(503) 645-3581
Mailing address
19435 NW MAHAMA WAY APT A, PORTLAND, OR 97229-3140
(360) 644-8220
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
01/08/2020
Last updated
01/08/2020
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