Healthcare Provider Details

I. General information

NPI: 1134035124
Provider Name (Legal Business Name): KAYLA CAIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18227 CHUCKAWA LN SE
YELM WA
98597-9076
US

IV. Provider business mailing address

706 3RD ST
RAINIER WA
98576-9514
US

V. Phone/Fax

Practice location:
  • Phone: 360-226-2388
  • Fax: 360-634-2032
Mailing address:
  • Phone: 360-226-2388
  • Fax: 360-634-2032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberCB.61212824
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: