Provider Demographics
NPI:1417486606
Name:MCKAY, COLIN BERT (DPM)
Entity Type:Individual
Prefix:DR
First Name:COLIN
Middle Name:BERT
Last Name:MCKAY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5593
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99302-5501
Mailing Address - Country:US
Mailing Address - Phone:509-606-2100
Mailing Address - Fax:509-606-2100
Practice Address - Street 1:915 GOETHALS DR
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3527
Practice Address - Country:US
Practice Address - Phone:509-943-1992
Practice Address - Fax:509-946-4418
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO61045453213ES0103X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery