Provider Demographics
NPI:1255741930
Name:BYLE, DOUG
Entity type:Individual
Prefix:
First Name:DOUG
Middle Name:
Last Name:BYLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 HENDERER RD
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:OR
Mailing Address - Zip Code:97436-9751
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:750 HENDERER RD
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:OR
Practice Address - Zip Code:97436-9751
Practice Address - Country:US
Practice Address - Phone:541-584-2750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORHTTPS://NPPES.CMS.HH163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse