Provider Demographics
NPI:1659499077
Name:MCKENZIE, STEVEN G (MS, PT, HPCS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:G
Last Name:MCKENZIE
Suffix:
Gender:M
Credentials:MS, PT, HPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19103 27TH DR SE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-6908
Mailing Address - Country:US
Mailing Address - Phone:425-882-1554
Mailing Address - Fax:425-883-1818
Practice Address - Street 1:19802 NE 148TH ST
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98077-7698
Practice Address - Country:US
Practice Address - Phone:425-882-1554
Practice Address - Fax:425-883-1818
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA9994225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist