DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: MCKENZIE PETERSON

MEDICARE: MCKENZIE PETERSON
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
1103TS0200XSchool PsychologistOR

General Provider Information

NPI Number : 1306798616
Entity Type Code : Individual
Provider Name (Legal Business Name) : MCKENZIE PETERSON
Provider Business Mailing Address
First Line : 2611 PRINGLE RD SE
Second Line :
City : SALEM
State : OR
Zip : 97302-1533
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2611 PRINGLE RD SE
Second Line :
City : SALEM
State : OR
Zip : 97302-1533
Country : US
Telephone Number : 503-385-4657
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2026
Last Update Date : 02/10/2026

Similar Medicare Providers

1881546125 — JUDY MARIE BARELA RN
Practice Location Address:
2611 PRINGLE RD SE
SALEM, OR
97302-1533
Practice Phone: 503-428-9853
Practice Fax:
1609728302 — TERRI LOUISE MINTON
Practice Location Address:
2611 PRINGLE RD SE
SALEM, OR
97302-1533
Practice Phone: 503-678-8441
Practice Fax:
1942150412 — MADISON MORRIS
Practice Location Address:
2611 PRINGLE RD SE
SALEM, OR
97302-1533
Practice Phone: 503-588-5330
Practice Fax:
1891721734 — LAUREN JOANN CLINTON AU. D.
Practice Location Address:
2611 PRINGLE RD SE
SALEM, OR
97302-1533
Practice Phone: 503-385-4582
Practice Fax: 503-540-4473
1366590655 — WILLAMETTE EDUCATION SERVICE DISTRICT
Practice Location Address:
2611 PRINGLE RD SE
SALEM, OR
97302-1533
Practice Phone: 503-385-4533
Practice Fax:
1730237488 — WILLAMETTE EDUCATION SERVICE DISTRICT
Practice Location Address:
2611 PRINGLE RD SE
SALEM, OR
97302-1533
Practice Phone: 503-588-5330
Practice Fax:

Directions to “ MCKENZIE PETERSON ” 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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.