Kavanaugh, Elizabeth Clare

Kavanaugh, Elizabeth Clare is an individual health care provider with primary practice located at 3181 Sw Sam Jackson Park Rd , Portland OR 97239-3011. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Kavanaugh, Elizabeth Clare can be contacted via phone (503) 494-4500.

Contact Information

Primary practice address
3181 Sw Sam Jackson Park Rd Portland OR 97239-3011
Phone: (503) 494-4500
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 088000583N5 Oregon
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 088000583RN Oregon

Profile Details

NPI number 1265539035
LBN Legal business name Kavanaugh, Elizabeth Clare
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265539035 NPPES
Oregon MEDICAID 210710

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