Individual
ELIZABETH BREANNA EVANGELISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 W FAIRVIEW ST, COLFAX, WA 99111-9552
(509) 397-3435
Mailing address
1200 W FAIRVIEW ST, COLFAX, WA 99111-9552
(509) 397-3435
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A198005
CA
207Q00000X
Family Medicine Physician
Primary
MD.MD.70004556
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2022
Last updated
08/19/2025
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