MEDICARE: KENIA E. AYALA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1841070091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENIA E. AYALA

Provider Business Mailing Address
First Line	:	23421 S HIGHWAY 213 UNIT 40
Second Line	:
City	:	OREGON CITY
State	:	OR
Zip	:	97045-9039
Country	:	US
Telephone Number	:	503-750-5671
Fax Number	:

Provider Business Practice Location Address
First Line	:	23421 S HIGHWAY 213 UNIT 40
Second Line	:
City	:	OREGON CITY
State	:	OR
Zip	:	97045-9039
Country	:	US
Telephone Number	:	503-750-5671
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2023
Last Update Date	:	10/06/2023

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Directions to “ KENIA E. AYALA ” Practice Location

Language	Start Address	Practice Location

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