Provider Demographics
NPI:1336940147
Name:WORLEY, KAYLA (EDS)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:WORLEY
Suffix:
Gender:
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2426 NW 168TH PL
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-8070
Mailing Address - Country:US
Mailing Address - Phone:505-615-8587
Mailing Address - Fax:
Practice Address - Street 1:2426 NW 168TH PL
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-8070
Practice Address - Country:US
Practice Address - Phone:505-615-8587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR154962103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool