Active NPI
Lue Ann Mackenzie, MLS
- Medical Technologist
- Portland, OR
National Provider Identifier
1710419734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Technologist
- License
- 258548
- Practice address
- 5440 NE Sandycrest Ter Apt 4
Portland, OR 97213-2651 - Phone
- (514) 870-0939
- NPI assigned
- Mar 29, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Technologist | 246QM0706X | 258548 | OR | Primary |
Addresses
Primary practice location
5440 NE Sandycrest Ter Apt 4
Portland, OR 97213-2651
Mailing address
5440 NE Sandycrest Ter Apt 4
Portland, OR 97213-2651
Phone (514) 870-0939
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 258548 | OR | MD | Medical Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490745600000",
"number": "1710419734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5440 NE SANDYCREST TER APT 4",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972132651",
"telephone_number": "514-870-0939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5440 NE SANDYCREST TER APT 4",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972132651",
"telephone_number": "514-870-0939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKENZIE",
"first_name": "LUE ANN",
"credential": "MLS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-29",
"last_updated": "2017-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "246QM0706X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Pathology, Medical Technologist",
"state": "OR",
"license": "258548",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.