Individual
KYLE RAYMOND JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2210 N ELDORADO AVE, KLAMATH FALLS, OR 97601-6418
(541) 883-1030
Mailing address
2210 N ELDORADO AVE, KLAMATH FALLS, OR 97601-6418
(541) 883-1030
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
23-11-10964
OR
1041C0700X
Clinical Social Worker
Primary
L16621
OR
Other
Enumeration date
02/01/2021
Last updated
06/30/2025
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