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Individual

LISA NICHOLE EVANOFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C, RD

Contact information

Practice address
4800 SAND POINT WAY NE, SEATTLE, WA 98105-3901
(206) 987-2000
Mailing address
4800 SAND POINT WAY NE, SEATTLE, WA 98105-3901

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
284656
MA
133V00000X
Registered Dietitian
DIET.DI.61590015
WA
363A00000X
Physician Assistant
Primary
PA.PA.70094994
WA

Other

Enumeration date
10/08/2021
Last updated
03/23/2026
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