Individual
MRS. KYLIE TAMIKO DEGUZMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3371
(503) 234-9591
Mailing address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3396
(503) 234-9591
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
08/01/2018
Last updated
03/29/2021
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