Provider Demographics
NPI:1689548752
Name:BOYER, MCKINZIE ANN (ND, LAC)
Entity type:Individual
Prefix:DR
First Name:MCKINZIE
Middle Name:ANN
Last Name:BOYER
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10868 S MULINO RD
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-9747
Mailing Address - Country:US
Mailing Address - Phone:971-533-3873
Mailing Address - Fax:
Practice Address - Street 1:6230 NE HALSEY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-4718
Practice Address - Country:US
Practice Address - Phone:971-279-2294
Practice Address - Fax:971-339-2971
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty