# MR. MICAH LASLEY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1225381130
- **Gender:** Man
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 60509731 | WA | Yes |
| 363AM0700X | Medical Physician Assistant | 5224 | AZ | — |

## Other

- **Enumeration date:** 10/17/2012
- **Last updated:** 10/13/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 5224 | OTHER | AZ |
| 05 | — | 5224 | — | AZ |
| 01 | — | 60509731 | WA STATE PA LICENSE | WA |