Provider Demographics
NPI:1487200440
Name:FOREMAN, KYLIE SHAYE (DOULA)
Entity Type:Individual
Prefix:
First Name:KYLIE
Middle Name:SHAYE
Last Name:FOREMAN
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:KYLIE
Other - Middle Name:SHAYE
Other - Last Name:FOREMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DOULA
Mailing Address - Street 1:52155 SE TUSSING WAY
Mailing Address - Street 2:
Mailing Address - City:SCAPPOOSE
Mailing Address - State:OR
Mailing Address - Zip Code:97056-0466
Mailing Address - Country:US
Mailing Address - Phone:503-840-9248
Mailing Address - Fax:
Practice Address - Street 1:52155 SE TUSSING WAY
Practice Address - Street 2:
Practice Address - City:SCAPPOOSE
Practice Address - State:OR
Practice Address - Zip Code:97056-0466
Practice Address - Country:US
Practice Address - Phone:503-840-9248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty