Individual
JEFFREY EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
801 E WHEELER RD, MOSES LAKE, WA 98837-1820
(509) 766-1301
(509) 766-1306
Mailing address
505 S 336TH ST, SUITE 600, FEDERAL WAY, WA 98003-6328
(253) 838-6180
(253) 838-6418
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OP00001301
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
218659
LIWA
WA
01
—
3075EV
BSWA
WA
05
—
8126237
—
WA
Enumeration date
03/08/2007
Last updated
02/27/2008
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