Individual
KYLE ROBBINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
173 NE 102ND AVE, PORTLAND, OR 97220-4169
(503) 906-9995
Mailing address
173 NE 102ND AVE, PORTLAND, OR 97220-4169
(503) 906-9995
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
18-CRM-226
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083010094
—
OR
Enumeration date
04/03/2019
Last updated
04/03/2019
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