Individual
KELLY CAVANAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
1285 SW CENTER ST, PULLMAN, WA 99163-5807
(509) 332-2629
Mailing address
1285 SW CENTER ST, PULLMAN, WA 99163-5807
(509) 332-2629
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
ID000025721E
ID
Other
Enumeration date
04/18/2018
Last updated
04/18/2018
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