Individual provider Active NPI

Michelle Kennedy Hedeen Mackenzie, MD

  • Family Medicine Physician
  • Bremerton, WA
National Provider Identifier
1790263143
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61450559 Issued in WA
Practice address
4207 Kitsap Way
Bremerton, WA 98312-2447
Phone
(360) 415-1080
Fax
(360) 415-1099
NPI assigned
Jul 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD61450559 WA Primary

Addresses

Primary practice location

4207 Kitsap Way
Bremerton, WA 98312-2447

Mailing address

1400 Pottery Ave
Port Orchard, WA 98366-3768
Phone (360) 895-5000

Other practice location 1

1400 Pottery Ave
Port Orchard, WA 98366-3768
Phone (360) 895-5000

Other names 1

  • Michelle Kathryn Hedeen Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241122002421 WA Practitioner - Family Practice 3375948193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Washington University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of WashingtonGroup PAC ID 9032022579, 1,519 clinicians

Practice addresses (Care Compare)

1400 Pottery Ave
Port Orchard, WA 98366-3711
Phone (360) 895-5000

Hospital & facility affiliations

  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108

Merit-based Incentive Payment System (MIPS)

Final score
90.26 of 100Reported as apm
Quality
89.39
Promoting interoperability
85.23
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Nov 1, 2025 Accepting new patients

Locations

1400 Pottery Ave
Port Orchard, WA 98366
Phone (360) 895-5000

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: mhedeen2952102@ghc.direct-ci.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1532822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772150400000",
    "number": "1790263143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 POTTERY AVE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663768",
            "telephone_number": "360-895-5000",
            "fax_number": "877-516-9023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4207 KITSAP WAY",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983122447",
            "telephone_number": "360-415-1080",
            "fax_number": "360-415-1099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Pottery Ave",
            "address_purpose": "LOCATION",
            "city": "Port Orchard",
            "state": "WA",
            "postal_code": "983663768",
            "country_code": "US",
            "telephone_number": "360-895-5000",
            "fax_number": "877-516-9023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKENZIE",
        "first_name": "MICHELLE",
        "middle_name": "KENNEDY HEDEEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-29",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61450559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1400 Pottery Ave",
            "city": "Port Orchard",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983663768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "HEDEEN",
            "middle_name": "KATHRYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bremerton, WA

Sources for this page

Verify at the official NPI Registry.