Individual
JOSEPH MARK EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11311 BRIDGEPORT WAY SW STE 205, LAKEWOOD, WA 98499-3051
(253) 985-2733
(253) 984-2049
Mailing address
11311 BRIDGEPORT WAY SW STE 205, LAKEWOOD, WA 98499-3051
(253) 985-2733
(253) 984-2049
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD20110
OR
208600000X
Surgery Physician
Primary
MD60653027
WA
2086S0102X
Surgical Critical Care Physician
MD20110
OR
2086S0102X
Surgical Critical Care Physician
MD60653027
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2002482
—
WA
Enumeration date
08/19/2006
Last updated
12/03/2020
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