Individual
G KEITH MACKENZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
715 S COWLEY ST, SUITE 228, SPOKANE, WA 99202-1375
(509) 624-9217
Mailing address
715 S COWLEY ST, SUITE 228, SPOKANE, WA 99202-1375
(509) 624-9217
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
15774
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508100
—
WA
Enumeration date
12/16/2005
Last updated
06/06/2012
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