Individual
KEVIN PATRICK FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 223-6980
Mailing address
1100 9TH AVE, M4-PFS, SEATTLE, WA 98101-2756
(206) 515-5811
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP61017573
WA
367500000X
Certified Registered Nurse Anesthetist
RN1020645
DC
Other
Enumeration date
06/10/2013
Last updated
07/23/2020
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