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1134862469
KYLE RANDALL
REDMOND, OR
NPI
1134862469
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR T-22-1471)
Enumeration Date
2022-04-14
Last Update Date
2022-04-14
Business Address
KYLE RANDALL
1470 NW 4TH ST
REDMOND, OR 97756-1366
Phone number: 541-316-7520
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Mailing Address
KYLE RANDALL
PO BOX 1710
REDMOND, OR 97756-0516
Phone number: 541-516-4097
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