Provider Demographics
NPI:1740325687
Name:MCKENZIE, PATRICK LINDQUIST (DDS)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:LINDQUIST
Last Name:MCKENZIE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 SOUTH PUGET DRIVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:RENTORI
Mailing Address - State:WA
Mailing Address - Zip Code:98055-4404
Mailing Address - Country:US
Mailing Address - Phone:425-228-1521
Mailing Address - Fax:425-228-0380
Practice Address - Street 1:1900 SOUTH PUGET DRIVE
Practice Address - Street 2:SUITE 102
Practice Address - City:RENTORI
Practice Address - State:WA
Practice Address - Zip Code:98055-4404
Practice Address - Country:US
Practice Address - Phone:425-228-1521
Practice Address - Fax:425-228-0380
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA4105122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5047477OtherDSHS