| Doctor Name: | TERESA MCKENZIE |
| NPI Number: | 1013298967 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CO60123119 |
| License Number: | CO60123119 |
| Business Practice Address: | 1026 E 1st St Suite 2 Port Angeles, WA - 983624020 |
| Business Phone Number: | 3604529836 |
| Business Fax Number: | |
| Mailing Address: | 1026 E 1st St Ste 2, PORT ANGELES |
| State: | WA |
| Postal Code: | 983624020 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 09/06/2011 |
| NPI Last Update Date: | 09/06/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | CO60123119 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |