Individual ProviderKyle CaudleCounselorBehavioral Health & Social Service ProvidersPractice Address10726 NE Glisan St, Portland, OR 97220-4046(503) 501-5252PECOS EnrollmentBased on the most recent information from CMS, provider Kyle Caudle does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1144618026Provider TypeIndividualFull NameCaudle, KyleGenderMaleSole ProprietorNoEnumeration Date12/31/2014Last Updated12/31/2014Contact InformationPractice LocationPractice Address10726 NE Glisan St, Portland, OR 97220-4046Phone(503) 501-5252FaxUnlisted FaxMailing LocationMailing Address10726 NE Glisan St, Portland, OR 97220-4046Phone(503) 501-5252FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer