Individual
KYLE CHASTAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10763 SW GREENBURG RD STE 100, TIGARD, OR 97223-5492
(503) 684-8159
(503) 598-0934
Mailing address
10763 SW GREENBURG RD STE 100, TIGARD, OR 97223-5492
(503) 684-8159
(503) 598-0934
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-25-4819
OR
Other
Enumeration date
02/03/2025
Last updated
02/03/2025
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