Most Relevant Information
Provider Data
| NPI Number: | 1003455916 |
| Provider Name: | RACQUEL CHERIE KAVANAUGH |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/26/2019 |
| Last Updated: | 12/30/2022 |
Provider Practice Location
18765 SW BOONES FERRY RD STE 100
TUALATIN
OR
970628607
Practice Location Phone/Fax
| Phone: | 9713414841 |
| Fax: |
Provider Mailing Location
9900 SE LAWNFIELD RD APT 22
CLACKAMAS
OR
970159613
Provider Mailing Phone/Fax
| Phone: | 9713414841 |
| Fax: |