Provider Demographics
NPI:1356701411
Name:DOYLE, KYLEE
Entity type:Individual
Prefix:
First Name:KYLEE
Middle Name:
Last Name:DOYLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KYLEE
Other - Middle Name:
Other - Last Name:PRESLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4255 SE MILE HILL DR STE 101
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-3920
Mailing Address - Country:US
Mailing Address - Phone:360-871-5200
Mailing Address - Fax:360-871-5350
Practice Address - Street 1:4255 SE MILE HILL DR STE 101
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-3920
Practice Address - Country:US
Practice Address - Phone:360-871-5200
Practice Address - Fax:360-871-5350
Is Sole Proprietor?:No
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60635479225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist