Individual ProviderMckenzie HansenFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address2011 4th St, La Grande, OR 97850-2511(541) 962-7808(541) 278-4332PECOS EnrollmentBased on the most recent information from CMS, provider Mckenzie Hansen is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1639952930Provider TypeIndividualFull NameHansen, MckenzieGenderFemaleSole ProprietorYesEnumeration Date8/18/2023Last Updated12/8/2023Contact InformationPractice LocationPractice Address2011 4th St, La Grande, OR 97850-2511Phone(541) 962-7808Fax(541) 429-6661Mailing LocationMailing AddressPO Box 1517, Pendleton, OR 97801-0410Phone(541) 278-4332Fax(541) 278-8349Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense64324Idaho