Individual
KYLE CASSIDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6601 NE 78TH CT, SUITE A3, PORTLAND, OR 97218-2823
(503) 232-3949
Mailing address
6601 NE 78TH CT, SUITE A3, PORTLAND, OR 97218-2823
(503) 232-3949
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/06/2016
Last updated
10/06/2016
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