Gordon K Mackenzie MD PS

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

MD 00015774 Issued in WA

Legal business name

GORDON K MACKENZIE MD PS

Practice address

715 S Cowley St
Suite 228
Spokane, WA 99202-1375

Phone

(509) 624-9217

Fax

(509) 623-2187

NPI assigned

Feb 5, 2010

Last updated

Jul 12, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jennie McKeen

Title

Office Manager

Phone

(509) 624-9217

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• G Keith Mackenzie MD PS Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1265328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342051200000",
    "number": "1720310469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 S COWLEY ST",
            "address_2": "SUITE 228",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021383",
            "telephone_number": "509-624-9217",
            "fax_number": "509-623-2187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 S COWLEY ST",
            "address_2": "SUITE 228",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021375",
            "telephone_number": "509-624-9217",
            "fax_number": "509-623-2187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON K MACKENZIE MD PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-05",
        "last_updated": "2012-07-12",
        "status": "A",
        "authorized_official_last_name": "MCKEEN",
        "authorized_official_first_name": "JENNIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "509-624-9217"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "MD 00015774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508100",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "G Keith Mackenzie MD PS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Christopher Goodwin, MD
• Nicholas Goodwin
• Srivalli Gopaluni, M.D.
• Olivia Gordin
• Cecilia Christine Gordner
• Bradley Gene Gordon, PHARMD
• Desiree A Gordon, MS AGENCY AFFILIATED
• Mark Steven Gordon, MD
• Shelby Mae Gordon, PT, DPT
• Tina T Gordon, CRNA

• Physical Medicine & Rehabilitation Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Physical Medicine & Rehabilitation Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.