Provider Demographics
NPI:1013671213
Name:DEVRIES, KYLE FRANCOIS MENETRIER (LMCHA, MS)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:FRANCOIS MENETRIER
Last Name:DEVRIES
Suffix:
Gender:M
Credentials:LMCHA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 BELLEVUE WAY SE APT 203
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6663
Mailing Address - Country:US
Mailing Address - Phone:405-837-1044
Mailing Address - Fax:
Practice Address - Street 1:1820 12TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-2438
Practice Address - Country:US
Practice Address - Phone:206-414-9365
Practice Address - Fax:844-364-8334
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61191366101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health