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1821073925

NPI Code Detail

MEDICARE: ALEXANDRA M MACKENZIE OTR/L, CHT

MEDICARE: ALEXANDRA M MACKENZIE OTR/L, CHT

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	225XH1200X	Hand Occupational Therapist	OT00003472	WA
2	225XH1200X	Hand Occupational Therapist	1003686	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	098565021	OTHER	OR	BCBS OF OR
2	173552	OTHER	WA	WA L&I
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821073925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA M MACKENZIE OTR/L, CHT

Provider Business Mailing Address
First Line	:	2330 NW FLANDERS ST
Second Line	:	STE G-1
City	:	PORTLAND
State	:	OR
Zip	:	97210-3442
Country	:	US
Telephone Number	:	503-224-9270
Fax Number	:	503-224-9271

Provider Business Practice Location Address
First Line	:	2330 NW FLANDERS ST
Second Line	:	STE G-1
City	:	PORTLAND
State	:	OR
Zip	:	97210-3442
Country	:	US
Telephone Number	:	503-224-9270
Fax Number	:	503-224-9271

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

Provider Enumeration Date	:	12/12/2005
Last Update Date	:	04/16/2021

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Directions to “ ALEXANDRA M MACKENZIE OTR/L, CHT” 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.

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