Mackenzie Fortner, SUDPT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDPT.CO.70105850 Issued in WA

Practice address

1601 E 4TH Plain Blvd BLDG 17
Vancouver, WA 98661-3717

Phone

(360) 903-7998

NPI assigned

Jul 8, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1657238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1811620511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 SE 121ST AVE APT 162",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986836094",
            "telephone_number": "360-953-3165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E 4TH PLAIN BLVD BLDG 17",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613717",
            "telephone_number": "360-903-7998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTNER",
        "first_name": "MACKENZIE",
        "credential": "SUDPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-08",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CDPT.CO.70105850",
            "primary": true
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "WA",
            "license": "NC61159336",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fort Vancouver Dental Centre
• Fort Vancouver Memory Care, LLC
• Fort Vancouver of Cascadia, LLC
• Fort Vancouver Post Acute, LLC
• Fortis Healthcare, Inc.
• Taizak Fortner, AAC
• Fortuna Adult Family Home LLC
• Forward Motion Physical Therapy LLC
• Bradley Justin Fosnot
• Nicole Ann Foss, LPN

• Addiction (Substance Use Disorder) Counselor in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; 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.