Provider Demographics
NPI:1710348420
Name:READ, KAYLEE (LMT)
Entity Type:Individual
Prefix:
First Name:KAYLEE
Middle Name:
Last Name:READ
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 COMMERCIAL ST SE
Mailing Address - Street 2:STE. 260
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-4172
Mailing Address - Country:US
Mailing Address - Phone:503-391-9222
Mailing Address - Fax:503-363-8193
Practice Address - Street 1:925 COMMERCIAL ST SE
Practice Address - Street 2:STE. 260
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4172
Practice Address - Country:US
Practice Address - Phone:503-391-9222
Practice Address - Fax:503-363-8193
Is Sole Proprietor?:No
Enumeration Date:2016-03-09
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist