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General NPI Number Information
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NPI Number | 1710494844
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Entity Type | Organization
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Legal Business Name | KAYLIN JONES, PH.D., LLC
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Dates
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Enumeration Date | 01/10/2018
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Last Update Date | 01/10/2018
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Provider Practice Location Address
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Address Line | 1235 SE DIVISION ST STE 115
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City | PORTLAND
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State | OR
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Zip | 97202-1085
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Country | US
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Telephone | 503-928-6346
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Fax |
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Provider Business Mailing Address
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Address Line | 1235 SE DIVISION ST STE 115
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City | PORTLAND
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State | OR
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Zip | 97202-1085
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Country | US
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Telephone | 503-928-6346
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Fax |
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Authorized Official
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Title or Position | OWNER/MEMBER
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Name | KAYLIN JONES
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Credential | PH.D.
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Telephone | 503-928-6346
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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 | 2874
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License Number State | OR
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