IndividualActive
Joseph Mackenzie, P.A. - C
NPI 1619077187 · Medical Physician Assistant · Portland, OR
Provider details
- NPI number
- 1619077187
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- P.A. - C
- Sex
- Male
- Sole proprietor
- No
- License
- PA00326 (OR)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Interstate Medical Office South
3500 N. Interstate Ave.
Portland, OR 97227-1196
Phone: (503) 285-9321
Approximate (ZIP-level) locationGet directions
Mailing address
1215 22nd Ave.
Longview, WA 98632-2823
Registry dates
- Enumerated
- 2006-09-25
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.