Individual
KAYLA CAVETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
9055 SW BEAVERTON HILLSDALE HWY STE A, PORTLAND, OR 97225-2438
(503) 644-4664
(503) 644-9005
Mailing address
9055 SW BEAVERTON HILLSDALE HWY STE A, PORTLAND, OR 97225-2438
(503) 644-4664
(503) 644-9005
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
6365701
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6364701
6365701
OR
Enumeration date
09/21/2009
Last updated
09/21/2009
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