Cavanagh, Michael K
Cavanagh, Michael K is an individual health care provider with primary practice located at 1802 Yakima Ave Ste 102 , Tacoma WA 98405-5303. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Cavanagh, Michael K can be contacted via phone (253) 272-7777.Contact Information
Primary practice address
1802 Yakima Ave Ste 102
Tacoma WA 98405-5303
Phone: (253) 272-7777
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA10003792 | Washington |
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA10003792 | Washington |
Profile Details
| NPI number | 1770529406 |
|---|---|
| LBN Legal business name | Cavanagh, Michael K |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 21st, 2006 |
| Last updated | Dec 2nd, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770529406 | NPPES |
| Washington | MEDICAID | 1045595 | |
| Washington | Other | P00220038 | |
| Washington | Other | 8926049 | |
| Washington | Other | 0127008 | |
| Washington | MEDICAID | 8403339 |
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