Provider Demographics
NPI:1073176756
Name:MAKENZIE, ALEXANDRA (DO)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:
Last Name:MAKENZIE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:MAKENZIE
Other - Last Name:SCOLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:34431 NE WOLCOTT ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-2202
Mailing Address - Country:US
Mailing Address - Phone:209-559-5663
Mailing Address - Fax:
Practice Address - Street 1:2529 NE 139TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98686-2719
Practice Address - Country:US
Practice Address - Phone:360-882-2778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-17
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADO.OP.61669767207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery