Individual
KYLE KALTWASSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1501 NE MEDICAL CENTER DR, BEND, OR 97701-6051
(541) 382-4900
Mailing address
1501 NE MEDICAL CENTER DR, BEND, OR 97701-6051
(541) 382-4900
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD224801
OR
207N00000X
Dermatology Physician
R8921
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500863701
—
OR
01
—
R274147
PTAN
OR
Enumeration date
05/08/2015
Last updated
01/25/2026
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