Individual
KYLA DIRKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
10315 NE TANASBOURNE DR, HILLSBORO, OR 97124-7836
(503) 495-8513
Mailing address
1518 E 3RD ST UNIT A, NEWBERG, OR 97132-3256
(503) 460-7174
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
15277
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750798955
—
OR
Enumeration date
07/20/2014
Last updated
12/20/2021
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