# MICHAEL K CAVANAGH

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1770529406
- **Gender:** Man
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA10003792 | WA | Yes |
| 363AS0400X | Surgical Physician Assistant | PA10003792 | WA | — |

## Other

- **Enumeration date:** 06/21/2006
- **Last updated:** 12/02/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0127008 | STATE L&I | WA |
| 05 | — | 1045595 | — | WA |
| 05 | — | 8403339 | — | WA |
| 01 | — | 8926049 | CRIME VICTIMS | WA |
| 01 | — | P00220038 | MEDICARE RAILROAD | WA |