Healthcare Provider Details

I. General information

NPI: 1942146402
Provider Name (Legal Business Name): MCKENZIE WILLAMETTE REGIONAL MEDICAL CENTER ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 G ST
SPRINGFIELD OR
97477-4112
US

IV. Provider business mailing address

1460 G ST
SPRINGFIELD OR
97477-4112
US

V. Phone/Fax

Practice location:
  • Phone: 541-726-4456
  • Fax: 541-726-3165
Mailing address:
  • Phone: 541-726-4401
  • Fax: 541-726-4540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: LAURA J FEY
Title or Position: VP PHYSICIAN PRACTICE FINANCIAL OPS
Credential:
Phone: 615-221-3641