Individual
KIT B O'BOYLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, BSN, MSW, LCSW
Contact information
Practice address
4733 NE 104TH AVE, PORTLAND, OR 97220-3347
(303) 990-2744
Mailing address
4798 NE GOING ST, PORTLAND, OR 97218-2002
(303) 990-2744
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L17485
OR
163WC0400X
Case Management Registered Nurse
201607356RN
OR
Other
Enumeration date
07/12/2018
Last updated
05/11/2026
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