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General NPI Number Information
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NPI Number | 1649788217
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Entity Type | Individual
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Provider Name | KYLE WEBSTER PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 01/17/2018
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Last Update Date | 09/12/2022
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Provider Practice Location Address
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Address Line | 705 N OAK HOLLOW DR
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City | NEWBERG
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State | OR
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Zip | 97132-7474
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Country | US
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Telephone | 661-889-3254
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Fax |
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Provider Business Mailing Address
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Address Line | 7340 SW HUNZIKER RD STE 210
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City | TIGARD
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State | OR
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Zip | 97223-2304
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Country | US
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Telephone | 503-352-0036
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3510
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License Number State | OR
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