Provider Demographics
NPI:1942239413
Name:LA CAVA, EDWARD COURTRIGHT (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:COURTRIGHT
Last Name:LA CAVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13118 - 121ST WAY NE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-3004
Mailing Address - Country:US
Mailing Address - Phone:425-899-6414
Mailing Address - Fax:425-899-4066
Practice Address - Street 1:13118 121ST WAY NE
Practice Address - Street 2:SUITE 103
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3004
Practice Address - Country:US
Practice Address - Phone:425-899-6414
Practice Address - Fax:425-899-4066
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00021741207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8868514Medicare PIN