MEDICARE: MACKENZIE GRAHAM ANDERSON DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	OP61577329	WA

General Provider Information

NPI Number	:	1568111060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MACKENZIE GRAHAM ANDERSON DO

Provider Business Mailing Address
First Line	:	2525 NE 139TH ST
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98686-2719
Country	:	US
Telephone Number	:	360-882-2778
Fax Number	:	360-604-1725

Provider Business Practice Location Address
First Line	:	2525 NE 139TH ST
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98686-2719
Country	:	US
Telephone Number	:	360-882-2778
Fax Number	:	360-604-1725

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2022
Last Update Date	:	06/08/2026

Similar Medicare Providers

1730014705 — VIVIAN RHODORA MARIE DARLUCIO SITU RN
Practice Location Address:

2525 NE 139TH ST
VANCOUVER, WA
98686-2719

Practice Phone: 360-882-2778
Practice Fax:

1285338293 — BARON UZOCHUKWU MD, MPH
Practice Location Address:

2525 NE 139TH ST
VANCOUVER, WA
98686-2719

Practice Phone: 360-882-2778
Practice Fax:

1891780524 — ALAN K MIRLY PA
Practice Location Address:

2525 NE 139TH ST STE 220
VANCOUVER, WA
98686-2719

Practice Phone: 360-882-2778
Practice Fax: 360-604-1616

1215924055 — DR. CRAIG CHARLES NEWLAND M.D.
Practice Location Address:

2525 NE 139TH ST , SUITE 140
VANCOUVER, WA
98686-2719

Practice Phone: 360-882-2778
Practice Fax: 360-604-1697

1194707224 — ANDREW CHARLES SAHNOW PT
Practice Location Address:

2525 NE 139TH ST
VANCOUVER, WA
98686-2719

Practice Phone: 360-882-2778
Practice Fax: 360-604-1676

1356320402 — CYNTHIA M ASHBAUGH FNP
Practice Location Address:

2525 NE 139TH ST
VANCOUVER, WA
98686-2719

Practice Phone: 360-882-2778
Practice Fax: 360-604-1675

Directions to “ MACKENZIE GRAHAM ANDERSON DO” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.