Provider Demographics
NPI:1558132894
Name:KYLE, KATE (DC)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:KYLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:KYLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:660 2ND ST APT 10
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-2345
Mailing Address - Country:US
Mailing Address - Phone:805-300-2378
Mailing Address - Fax:
Practice Address - Street 1:9320 SW BARBUR BLVD STE 255
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-5440
Practice Address - Country:US
Practice Address - Phone:503-226-8010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-15
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6358111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor