Provider Demographics
NPI:1407366743
Name:SIGLER, MCKENZE
Entity Type:Individual
Prefix:
First Name:MCKENZE
Middle Name:
Last Name:SIGLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 S 11TH AVE STE A
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3212
Mailing Address - Country:US
Mailing Address - Phone:509-902-8585
Mailing Address - Fax:509-902-8030
Practice Address - Street 1:314 S 11TH AVE STE A
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3212
Practice Address - Country:US
Practice Address - Phone:509-902-8585
Practice Address - Fax:509-902-8030
Is Sole Proprietor?:No
Enumeration Date:2017-09-30
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60767337363L00000X
WASTUDENT363L00000X
WAAP60879545363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner