Individual
KYLE HIGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
5725 NE PRESCOTT ST, PORTLAND, OR 97218-2275
(503) 493-4258
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L6053
OR
Other
Enumeration date
07/07/2014
Last updated
07/17/2014
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