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NPI Code Detail

MEDICARE: MARGRET ANGELA KAVANAGH LMT, SUDP

MEDICARE: MARGRET ANGELA KAVANAGH LMT, SUDP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorCP60941313WA
2172M00000XMechanotherapistMA00020835WA

General Provider Information

NPI Number : 1992991376
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARGRET ANGELA KAVANAGH LMT, SUDP
Provider Business Mailing Address
First Line : 515 LAKEWAY DR
Second Line :
City : BELLINGHAM
State : WA
Zip : 98225-5233
Country : US
Telephone Number : 360-676-2187
Fax Number :
Provider Business Practice Location Address
First Line : 515 LAKEWAY DR
Second Line :
City : BELLINGHAM
State : WA
Zip : 98225-5233
Country : US
Telephone Number : 360-676-2187
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2007
Last Update Date : 02/19/2021

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