Individual
KYLA MARIE FUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4410 MONROE AVE NE, SALEM, OR 97301-4934
(503) 559-8300
Mailing address
4410 MONROE AVE NE, SALEM, OR 97301-4934
(503) 559-8300
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/16/2026
Last updated
03/16/2026
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