Provider Demographics
NPI:1457086068
Name:CLOTHIER, KAYLEY
Entity Type:Individual
Prefix:
First Name:KAYLEY
Middle Name:
Last Name:CLOTHIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 MONROE PKWY STE 270
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-8866
Mailing Address - Country:US
Mailing Address - Phone:503-675-2830
Mailing Address - Fax:503-675-2852
Practice Address - Street 1:9 MONROE PKWY STE 270
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-8866
Practice Address - Country:US
Practice Address - Phone:503-675-2830
Practice Address - Fax:503-675-2852
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health