Provider Demographics
NPI:1255414223
Name:MCAVOY, KYLE BELL (NP)
Entity type:Individual
Prefix:MRS
First Name:KYLE
Middle Name:BELL
Last Name:MCAVOY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:120 NW 14TH AVE.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97409
Mailing Address - Country:US
Mailing Address - Phone:503-771-1883
Mailing Address - Fax:971-222-1391
Practice Address - Street 1:120 NW 14TH AVE.
Practice Address - Street 2:SUITE 200
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97409
Practice Address - Country:US
Practice Address - Phone:503-771-1883
Practice Address - Fax:971-222-1391
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR083039267N1 FNP PP363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health