Individual
KYLE PERNULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
10151 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-6913
(503) 647-6456
Mailing address
10151 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-6913
(503) 647-6456
(503) 296-2022
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA217844
OR
363A00000X
Physician Assistant
—
—
Other
Enumeration date
02/26/2024
Last updated
05/30/2024
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