Provider Demographics
NPI:1568083160
Name:FURGASON, MCKENZIE (AUD)
Entity type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:
Last Name:FURGASON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:MCKENZIE
Other - Middle Name:
Other - Last Name:ARNOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 HILYARD ST STE 620
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-8157
Mailing Address - Country:US
Mailing Address - Phone:458-205-6500
Mailing Address - Fax:
Practice Address - Street 1:1200 HILYARD ST STE 620
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-8157
Practice Address - Country:US
Practice Address - Phone:458-205-6500
Practice Address - Fax:458-205-6453
Is Sole Proprietor?:No
Enumeration Date:2020-05-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
OR31116231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician