Individual
DR. JARED DEAN EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1327 N STANFORD LN, SUITE B, LIBERTY LAKE, WA 99019-5034
(509) 891-7070
(509) 891-4741
Mailing address
1327 N STANFORD LN, SUITE B, LIBERTY LAKE, WA 99019-5034
(509) 891-7070
(509) 891-4741
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DE00010191
WA
1223P0221X
Pediatric Dentistry
DN16714
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5048236
—
WA
05
—
5050513
—
WA
Enumeration date
10/18/2006
Last updated
07/27/2012
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