Roger C Lafavor, PAC
Physician Assistant, Surgical in Seattle, WA. Individual provider (NPI-1).
NPI number1477586535
StatusActive
Last updated in NPPESOct 10, 2011
Details
- NPI
- 1477586535
- Entity type
- Individual (NPI-1)
- Name
- Mr. Roger C Lafavor
- Credential
- PAC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 9, 2006
- Last updated
- Oct 10, 2011
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | PA10002191 | WA | Yes |
Practice location
601 BroadwaySeattle, WA 98122-5330
Phone 206-386-2600 · Fax 206-622-1644
Mailing address
805 Madison StSuite 901
Seattle, WA 98104-1172
Phone 206-226-4810 · Fax 206-264-8689
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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