Healthcare Provider Details

I. General information

NPI: 1255012555
Provider Name (Legal Business Name): CHELSEY CHINATSU MCKENZIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2023
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 S COLUMBIAN WAY
SEATTLE WA
98108-1532
US

IV. Provider business mailing address

887 NW SCENIC VISTA ST
OAK HARBOR WA
98277-7266
US

V. Phone/Fax

Practice location:
  • Phone: 206-762-1010
  • Fax:
Mailing address:
  • Phone: 360-969-6093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN60654442
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: