Healthcare Provider Details

I. General information

NPI: 1205573169
Provider Name (Legal Business Name): HAILEY KALE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2022
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 NW BETHANY BLVD STE 320
BEAVERTON OR
97006-5238
US

IV. Provider business mailing address

16187 NW HILDAGO LN
PORTLAND OR
97229-1120
US

V. Phone/Fax

Practice location:
  • Phone: 503-567-3260
  • Fax:
Mailing address:
  • Phone: 360-701-4149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC8686
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: