NPI 1023621950

Kyle Brent Odesha

Practitioner Case Manager/Care Coordinator Medford, OR

Practice location

Address: 200 Beatty St, Medford, OR 97501-5811
Phone: (541) 476-2373
Mailing address: 1215 SW G St, Grants Pass, OR 97526-2544

Registered specialties (3)

Case Manager/Care Coordinator Primary

Other Service Providers Taxonomy 171M00000X

Other Case Manager/Care Coordinator providers in Oregon →

Mental Health Counselor

Behavioral Health & Social Service Providers Taxonomy 101YM0800X

Other Counselor providers in Oregon →

Community Health Worker

Other Service Providers Taxonomy 172V00000X

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Registry record

NPI: 1023621950
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Aug 2020
Record last updated: 29 Dec 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.