Healthcare Provider Details

I. General information

NPI: 1114094570
Provider Name (Legal Business Name): BRENDA S. MCKENZIE PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRENDA S. KEPLEY

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4060 E STEVENS WAY NE
SEATTLE WA
98195-6008
US

IV. Provider business mailing address

PO BOX 50095
SEATTLE WA
98145-5095
US

V. Phone/Fax

Practice location:
  • Phone: 206-597-5242
  • Fax:
Mailing address:
  • Phone: 206-520-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT00008683
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: