NPI 1003455916

Racquel Cherie Kavanaugh

Practitioner Case Manager/Care Coordinator Tualatin, OR

Practice location

Address: 18765 SW Boones Ferry Rd STE 100, Tualatin, OR 97062-8607
Phone: (971) 341-4841
Mailing address: 9900 SE Lawnfield Rd APT 22, Clackamas, OR 97015-9613

Registered specialties (2)

Case Manager/Care Coordinator Primary

Other Service Providers Taxonomy 171M00000X

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Behavior Technician

Behavioral Health & Social Service Providers Taxonomy 106S00000X Licence IN10211971 (OR)

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Registry record

NPI: 1003455916
Entity type: Individual
Sex (as registered): Female
NPI issued: 26 Dec 2019
Record last updated: 30 Dec 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.