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Individual

DR. LAUREL RENEE KASH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
677 S LOWELL ST APT S664, PORTLAND, OR 97239-4816
(503) 997-8296
Mailing address
677 S LOWELL ST APT S664, PORTLAND, OR 97239-4816
(503) 997-8296

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
837215
OR
174400000X
Specialist
837215
OR
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
837215
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
837215
EXPRS MEDICAID PROVIDER NUMBER
OR
Enumeration date
01/05/2022
Last updated
01/05/2022
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