Provider Demographics
NPI:1568833036
Name:NAYFIELD, KYLE (LSWAIC)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:NAYFIELD
Suffix:
Gender:M
Credentials:LSWAIC
Other - Prefix:
Other - First Name:KY
Other - Middle Name:
Other - Last Name:NAYFIELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LSWAIC
Mailing Address - Street 1:PO BOX 34703
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1703
Mailing Address - Country:US
Mailing Address - Phone:206-764-0502
Mailing Address - Fax:
Practice Address - Street 1:3350 AIRPORT DR
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-7696
Practice Address - Country:US
Practice Address - Phone:360-734-5458
Practice Address - Fax:360-734-5298
Is Sole Proprietor?:No
Enumeration Date:2015-10-09
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC60408353104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker