Provider Demographics
NPI:1851530570
Name:MCKINNIE, AMBER (MSW)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:MCKINNIE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14195 SW MILLIKAN WAY
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-2307
Mailing Address - Country:US
Mailing Address - Phone:503-644-2545
Mailing Address - Fax:503-644-0379
Practice Address - Street 1:14195 SW MILLIKAN WAY
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-2307
Practice Address - Country:US
Practice Address - Phone:503-644-2545
Practice Address - Fax:503-644-0379
Is Sole Proprietor?:No
Enumeration Date:2009-02-19
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical