Provider Demographics
NPI:1104689504
Name:FINNEY, MCKENNA (RDH)
Entity type:Individual
Prefix:
First Name:MCKENNA
Middle Name:
Last Name:FINNEY
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:MCKENNA
Other - Middle Name:
Other - Last Name:DRAKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:1065 W JONES DR
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-1001
Mailing Address - Country:US
Mailing Address - Phone:541-499-9584
Mailing Address - Fax:
Practice Address - Street 1:1094 ROYAL CT
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6138
Practice Address - Country:US
Practice Address - Phone:541-779-4344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH7627124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist