Individual provider · Type 1 NPI

Mackenzie Fortner, SUDPT

Addiction (Substance Use Disorder) Counselor · Vancouver, WA

NPI number 1811620511 Active

Practice location

1601 E 4th Plain Blvd Bldg 17
Vancouver, WA 98661-3717

Call (360) 903-7998 Map

Mailing address

600 SE 121st Ave Apt 162
Vancouver, WA 98683-6094

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XCDPT.CO.70105850 (WA)
Nurse's Aide 376K00000XNC61159336 (WA)
Peer Specialist 175T00000XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1811620511

Mackenzie Fortner, SUDPT's National Provider Identifier is 1811620511, issued on Jul 8, 2022. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Vancouver, WA. The record was last updated on Apr 7, 2026.