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Individual

MS. EVELINA AVETISOVA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
AGPC-NP

Contact information

Practice address
15214 AURORA AVE N, SHORELINE, WA 98133-6143
(888) 405-6396
(415) 252-7176
Mailing address
104 SOLOMON RD APT G302, KELSO, WA 98626-1772
(323) 372-4190

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
10017243
OR
363LG0600X
Gerontology Nurse Practitioner
Primary
AP61494666
WA

Other

Enumeration date
10/12/2023
Last updated
09/17/2025
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