Provider Demographics
NPI:1043372303
Name:MALOY, KENZIE LYNNE (DC)
Entity Type:Individual
Prefix:DR
First Name:KENZIE
Middle Name:LYNNE
Last Name:MALOY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KENZIE
Other - Middle Name:LYNNE
Other - Last Name:SATTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1000 S. HWY 395, PMB A505
Mailing Address - Street 2:
Mailing Address - City:HERMISTON
Mailing Address - State:OR
Mailing Address - Zip Code:97838-0211
Mailing Address - Country:US
Mailing Address - Phone:541-371-3700
Mailing Address - Fax:541-515-7022
Practice Address - Street 1:115 W HERMISTON AVE STE 130
Practice Address - Street 2:
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838-1762
Practice Address - Country:US
Practice Address - Phone:541-371-3700
Practice Address - Fax:541-515-7022
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3653111N00000X
OR10013913363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor