Individual
KYLEE DOETSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
655 N 8TH ST, HARRISBURG, OR 97446-9552
(208) 512-9710
Mailing address
655 N 8TH ST, HARRISBURG, OR 97446-9552
(208) 512-9710
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
175T00000X
OR
Other
Enumeration date
06/08/2023
Last updated
06/08/2023
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