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NPI Code Detail

MEDICARE: MAKENZY LUNDGREN BIRTH DOULA

MEDICARE: MAKENZY LUNDGREN BIRTH DOULA
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
1374J00000XDoula113363OR
2175T00000XPeer Specialist113363OR

General Provider Information

NPI Number : 1659170660
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAKENZY LUNDGREN BIRTH DOULA
Provider Business Mailing Address
First Line : 11630 DAHLIA TER
Second Line :
City : OREGON CITY
State : OR
Zip : 97045-6727
Country : US
Telephone Number : 503-559-6685
Fax Number :
Provider Business Practice Location Address
First Line : 6200 SE KING RD
Second Line :
City : PORTLAND
State : OR
Zip : 97222-2891
Country : US
Telephone Number : 503-267-3129
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2025
Last Update Date : 06/01/2026

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Directions to “ MAKENZY LUNDGREN BIRTH DOULA” Practice Location

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