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Individual

DR. EVONN LB O'NEILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
5952 BLACKSTONE WAY, NINE MILE FALLS, WA 99026-4900
(509) 464-3627
(509) 466-9517
Mailing address
5952 BLACKSTONE WAY, NINE MILE FALLS, WA 99026-4900
(509) 464-3627
(509) 466-9517

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00036446
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0198643
WORKERS COMPENSATION
WA
05
8250649
WA
01
8906391
CRIME VICTIM COMPENSATION
WA
Enumeration date
05/15/2006
Last updated
05/09/2013
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