Provider Demographics
NPI:1235433400
Name:SEITZ, KAYLE FAYE (LAC)
Entity Type:Individual
Prefix:MRS
First Name:KAYLE
Middle Name:FAYE
Last Name:SEITZ
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17831 SE CANDY LN
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97267-6522
Mailing Address - Country:US
Mailing Address - Phone:360-440-6129
Mailing Address - Fax:
Practice Address - Street 1:17831 SE CANDY LN
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97267-6522
Practice Address - Country:US
Practice Address - Phone:360-440-6129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-03
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC153032171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist