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Individual

CAITLIN STAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
11675 SW PACIFIC HWY, TIGARD, OR 97223-8672
(503) 305-6262
Mailing address
7927 RANDALL DR, LENEXA, KS 66215-6109
(563) 370-9485

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
14-148494-012
KS
363L00000X
Nurse Practitioner
Primary
10019683
OR

Other

Enumeration date
08/21/2023
Last updated
05/07/2024
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