Individual
ELIZABETH CLARE KAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-4500
Mailing address
3014 SE WOODWARD ST, PORTLAND, OR 97202-1460
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
088000583N5
OR
367A00000X
Advanced Practice Midwife
088000583RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210710
—
OR
Enumeration date
09/20/2006
Last updated
07/08/2007
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