Individual
KAYLA MAE EVERSOLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1815 SW MARLOW AVE STE 100, PORTLAND, OR 97225-5185
(503) 935-8100
(503) 935-8110
Mailing address
541 NE 20TH AVE STE 225, PORTLAND, OR 97232-2895
(503) 963-2801
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA221668
OR
363AM0700X
Medical Physician Assistant
61328609
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500847260
—
OR
Enumeration date
09/01/2020
Last updated
10/14/2025
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