Provider Demographics
NPI:1619594686
Name:THAMERT, KAYLA JEAN (ND)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:JEAN
Last Name:THAMERT
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12697 SE 31ST AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-7066
Mailing Address - Country:US
Mailing Address - Phone:509-948-4103
Mailing Address - Fax:
Practice Address - Street 1:12697 SE 31ST AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-7066
Practice Address - Country:US
Practice Address - Phone:509-948-4103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-25
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes175F00000XOther Service ProvidersNaturopath