Kevin Bernard Finnigan, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA10005138 Issued in WA

Practice address

17926 69TH Ave E
Puyallup, WA 98375-2474

Phone

(253) 303-1052

NPI assigned

May 3, 2006

Last updated

Jun 29, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lake Tapps Family Medicine, PLLC

  dba Lake Tapps Family Medicine

  • Family Medicine Physician
  • Lake Tapps, WA
  • NPI 1245406032
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214697600000",
    "number": "1609834027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17926 69TH AVE E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983752474",
            "telephone_number": "253-303-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17926 69TH AVE E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983752474",
            "telephone_number": "253-303-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINNIGAN",
        "first_name": "KEVIN",
        "middle_name": "BERNARD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2008-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10005138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Lee Fink, RDH
• Dianna Marie Finlay
• Anne Finley
• Ethan Jameson Finley, LMT
• Ryan Patrick Finn, D.O.
• Cassandra Fiorina, LICSW
• Laura Elayne Firetag, ND
• Erika Fisch
• Stephanie Virginia Fischer, LMT
• Holly Fish, MD

• Medical Physician Assistant in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.