Healthcare Provider Details

I. General information

NPI: 1689578015
Provider Name (Legal Business Name): KAYLA CAROLINA CASTILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 N COLUMBIA ST
MILTON FREEWATER OR
97862-1368
US

IV. Provider business mailing address

550 W SPERRY STREET PO BOX 469
HEPPNER OR
97836
US

V. Phone/Fax

Practice location:
  • Phone: 541-276-6207
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: