Mccrorey, Mackenzie Anne

Mccrorey, Mackenzie Anne is an sole proprietor health care provider with primary practice located at 10000 Se Main St Ste 365 , Portland OR 97216-2474. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is her primary health care specialty. Mccrorey, Mackenzie Anne can be contacted via phone (503) 261-4430.

Contact Information

Primary practice address
10000 Se Main St Ste 365 Portland OR 97216-2474
Phone: (503) 261-4430
Fax: (503) 261-4436
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085003524 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 085003524 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA195380 Oregon

Profile Details

NPI number 1023271632
LBN Legal business name Mccrorey, Mackenzie Anne
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 3rd, 2008
Last updated Jan 10th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023271632 NPPES
Illinois Other P01216933 MEDICARE RAILROAD (PROVIDER PTAN)
Illinois Other 206147 MEDICARE RAILROAD (PROVIDER PTAN)
Illinois Other 206147235 MEDICARE RAILROAD (PROVIDER PTAN)
Illinois Other CA4748 MEDICARE RAILROAD (PROVIDER PTAN)

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