MACKENZIE RUSSELL (NPI# 1215554472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215554472 |
| Entity Type | Individual |
| Full Name | MACKENZIE RUSSELL |
| Credential | SLP |
| Practice Address |
304 Ne Hood Ave Gresham OR 97030-7450 |
| Practice Telephone | 5036661333 |
| Practice Fax Number | 5036662444 |
| Mailing Telephone | 5036661333 |
| Mailing Fax Number | 5036662444 |
| Enumeration Date | 2020-07-02 |
| Last Update Date | 2020-07-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | 016695 | OR | Speech, Language and Hearing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | SPEECH AND LANGUAGE PATHOLOGY BOARD | 016695 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144688847 | Mackenzie Russell | Behavioral Analyst | 5957 S Gallup St, Unit 201, Littleton, CO 80120-2742 | 2016-02-09 |
| Street Address |
304 NE HOOD AVE |
| City | GRESHAM |
| State | OR |
| Zip Code | 97030-7450 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336676634 | Kristen Erich | Physical Medicine & Rehabilitation | 304 Ne Hood Ave, Gresham, OR 97030-7450 | 2017-05-17 |
| 1578161261 | Mollie Wang | Occupational Therapist | 304 Ne Hood Ave, Gresham, OR 97030-7450 | 2020-10-14 |
| 1790398816 | Brooke Demarest | Occupational Therapist | 304 Ne Hood Ave, Gresham, OR 97030-7450 | 2020-08-28 |
| 1992318000 | Ellee Daskalos Nakashima | Physical Therapist | 304 Ne Hood Ave, Gresham, OR 97030-7450 | 2020-08-28 |
| 1932726197 | Katherine Lynn Woodworth | Occupational Therapist | 304 Ne Hood Ave, Gresham, OR 97030-7450 | 2020-07-02 |
| 1114543329 | Mckenzie Carol Rushcamp | Speech-Language Pathologist | 304 Ne Hood Ave, Gresham, OR 97030-7450 | 2020-06-23 |
| 1164055539 | Jamie G Morton | Occupational Therapist | 304 Ne Hood Ave, Gresham, OR 97030-7450 | 2020-02-13 |
| 1821621293 | Abigail Katheryn Feltner Smith | Occupational Therapist | 304 Ne Hood Ave, Gresham, OR 97030-7450 | 2020-02-13 |
| 1588213896 | Paige Ryan Rhodes | Physical Therapist | 304 Ne Hood Ave, Gresham, OR 97030-7450 | 2019-09-09 |
| 1477100170 | Karla Gill | Speech-Language Pathologist | 304 Ne Hood Ave, Gresham, OR 97030-7450 | 2019-08-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174032312 | Tiffany Chen | Occupational Therapist | 304 Ne Hood Ave., Gresham, OR 97030 | 2017-09-20 |
| 1225568454 | Goldstar Vascular Access, Inc | Home Infusion | 2870 Ne Hogan Dr, Ste E #205, Gresham, OR 97030 | 2017-06-20 |
| 1861940454 | Jessica Morrow | Massage Therapist | 1748 Nw Fairview Dr., Gresham, OR 97030 | 2016-09-13 |
| 1033665898 | Bonita Baxter | Counselor | 400 Ne 7th Street, Gresham, OR 97030 | 2016-08-31 |
| 1710335484 | Ethan William Hoccom | Counselor | 1527 Ne Lamesa Place 17th St, Gresham, OR 97030 | 2016-06-02 |
| 1992159610 | Kathleen Kline, Lmt | Massage Therapist | 1217 Ne Burnside Road Suite 701-d, Gresham, OR 97030 | 2016-04-19 |
| 1215390109 | The Wallace Medical Concern | Nurse Practitioner | 254 Nw Burnside Road, Gresham, OR 97030 | 2016-03-30 |
| 1932568912 | Atchison Dialysis, LLC | Clinic/Center | 878 Nw Burnside Rd, Gresham, OR 97030 | 2016-02-18 |
| 1912374034 | Hilary Dawn Montgomery | Counselor | 1326 Nw Civic Dr # 5569, Gresham, OR 97030 | 2015-08-24 |
| 1992171730 | Melissa E Childs | Massage Therapist | 1217 Nw Burnside Rd Ste 701, Gresham, OR 97030 | 2015-08-17 |
| Find all providers in zip 97030 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649804048 | Gayla Ann Iwata-reuyl | Speech-Language Pathologist | 24900 Se Stark St Ste 106, Gresham, OR 97030-3381 | 2020-02-25 |
| 1326696048 | Heather Marie Wright | Speech-Language Pathologist | 908 Se 9th St, Gresham, OR 97080-8102 | 2019-08-27 |
| 1992359723 | Lynette Marie Sestric | Speech-Language Pathologist | 4632 Se Oxbow Pkwy, Gresham, OR 97080-8967 | 2019-07-30 |
| 1407200843 | Melissa Anne Bohnstedt | Speech-Language Pathologist | 6540 Se 182nd Ave, Gresham, OR 97080-3250 | 2016-04-22 |
| 1598148355 | Kimberly Vestal | Speech-Language Pathologist | 3860 Ne View Pl, Gresham, OR 97030-2123 | 2015-06-29 |
| 1467733667 | Kathleen Elaine Phillips | Speech-Language Pathologist | 1218 Sw 14th Ct, Gresham, OR 97080-9620 | 2011-08-31 |
| 1801987516 | Jill Gigi Russell | Speech-Language Pathologist | 1456 Se Condor Ave, Gresham, OR 97080-6123 | 2006-09-27 |
| 1700842531 | Pediatric Therapy Services Inc | Speech-Language Pathologist | 7927 Se Orient Drive, Gresham, OR 97080 | 2006-04-21 |
| 1639141898 | Cara R Lacey-morey | Speech-Language Pathologist | 550 Ne Scott Ave, Gresham, OR 97030-6147 | 2006-02-02 |
| 1245844521 | Rachael Anne Iverson | Speech-Language Pathologist | 7927 Se Orient Dr, Gresham, OR 97080-8847 | 2020-09-03 |
| Find all providers in GRESHAM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.