# MR. KEVIN R LAFAVE

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

## Provider details

- **NPI number:** 1265477129
- **Gender:** Man
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA10004138 | WA | Yes |

## Other

- **Enumeration date:** 06/17/2006
- **Last updated:** 04/26/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0150556 | LIWA | WA |
| 01 | — | 0150557 | LIWA | WA |
| 01 | — | 1594LA | BSWA | WA |
| 01 | — | 1913LA | BSWA | WA |
| 01 | — | 2164NO | BSWA | WA |
| 05 | — | 8348914 | — | WA |