Provider Demographics
NPI:1962541052
Name:MCKAY, DEBORAH SUSANNE (ND)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:SUSANNE
Last Name:MCKAY
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7516 SW 25TH AVE.
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-2530
Mailing Address - Country:US
Mailing Address - Phone:503-549-5550
Mailing Address - Fax:503-549-5550
Practice Address - Street 1:7516 SW 25TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-2530
Practice Address - Country:US
Practice Address - Phone:503-549-5550
Practice Address - Fax:503-549-5550
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1444175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath