Provider Demographics
NPI:1528710118
Name:KUNST, MACKENZIE ANN (OT)
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:ANN
Last Name:KUNST
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:MACKENZIE
Other - Middle Name:ANN
Other - Last Name:KOEHLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3369
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3369
Mailing Address - Country:US
Mailing Address - Phone:866-747-2455
Mailing Address - Fax:425-690-9513
Practice Address - Street 1:900 PACIFIC AVE FL 1
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4168
Practice Address - Country:US
Practice Address - Phone:425-258-7311
Practice Address - Fax:425-258-7618
Is Sole Proprietor?:No
Enumeration Date:2022-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist