Provider Demographics
NPI:1073210902
Name:PAYNE, KAYLA (LMT)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:PAYNE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18990 SW ROSEDALE CT
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-5642
Mailing Address - Country:US
Mailing Address - Phone:503-869-0500
Mailing Address - Fax:
Practice Address - Street 1:7598 NE SHALEEN ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-9430
Practice Address - Country:US
Practice Address - Phone:503-462-7977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist