Individual
KAYLA KUBISCHTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8285 SW NIMBUS AVE STE 148, BEAVERTON, OR 97008-6465
(360) 567-2211
(360) 423-5086
Mailing address
8285 SW NIMBUS AVE STE 148, BEAVERTON, OR 97008-6465
(503) 352-3260
(503) 352-3262
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
60824144
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2098021
—
WA
Enumeration date
07/19/2017
Last updated
10/30/2020
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