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NPI Code Detail

MEDICARE: KAYLA MARIE ARIZ ESTRADA

MEDICARE: KAYLA MARIE ARIZ ESTRADA
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
1101YM0800XMental Health Counselor
2103TF0000XFamily Psychologist
3103TS0200XSchool Psychologist
4103TC2200XClinical Child & Adolescent Psychologist

General Provider Information

NPI Number : 1912744699
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA MARIE ARIZ ESTRADA
Provider Business Mailing Address
First Line : 4900 SW GRIFFITH DR STE 157
Second Line :
City : BEAVERTON
State : OR
Zip : 97005-2977
Country : US
Telephone Number : 503-444-8230
Fax Number :
Provider Business Practice Location Address
First Line : 4900 SW GRIFFITH DR STE 157
Second Line :
City : BEAVERTON
State : OR
Zip : 97005-2977
Country : US
Telephone Number : 503-444-8230
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2024
Last Update Date : 07/10/2024

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Directions to “ KAYLA MARIE ARIZ ESTRADA ” Practice Location

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