Individual
KIMBERLY C EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. SPED
Contact information
Practice address
3214 W MCGRAW ST STE 212, SEATTLE, WA 98199-3239
(206) 453-4882
Mailing address
12724 LAKE CITY WAY NE APT A403, SEATTLE, WA 98125-4454
(480) 248-5312
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
CG60573410
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG60573410
AGENCY AFFILIATED COUNSELOR PENDING CREDENTIAL NUMBER
WA
Enumeration date
06/03/2015
Last updated
06/03/2015
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