Healthcare Provider Details

I. General information

NPI: 1588690390
Provider Name (Legal Business Name): REBECCA A. KYLE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 NE NEFF RD
BEND OR
97701-6015
US

IV. Provider business mailing address

11750 SW BARNES RD STE 300
PORTLAND OR
97225-5911
US

V. Phone/Fax

Practice location:
  • Phone: 541-706-4984
  • Fax: 541-706-5925
Mailing address:
  • Phone: 503-416-9922
  • Fax: 503-416-9970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberDO28089
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: