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General NPI Number Information
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NPI Number | 1508765132
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Entity Type | Individual
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Provider Name | HAILEY MC KENZIE SARNACKI CADC, QMHA
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Gender | Female
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Dates
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Enumeration Date | 11/02/2026
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Last Update Date | 11/02/2026
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Provider Practice Location Address
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Address Line | 2072 NE BURNSIDE RD
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City | GRESHAM
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State | OR
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Zip | 97030-7950
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Country | US
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Telephone | 971-436-2560
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Fax |
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Provider Business Mailing Address
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Address Line | 7000 SW VARNS ST
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City | TIGARD
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State | OR
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Zip | 97223-8006
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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