Individual
KELLY L EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4545 CORDATA PKWY, BELLINGHAM, WA 98226-7123
(360) 738-2200
(360) 752-5686
Mailing address
PO BOX 5096, BELLINGHAM, WA 98227-5096
(360) 738-2200
(360) 752-5686
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
36096988
IL
207Q00000X
Family Medicine Physician
Primary
MD60114770
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031EV
REGENCE
WA
01
—
0261814
L&I AND CRIME VICTIMS
WA
05
—
036096988
—
IL
05
—
1700887338
—
WA
01
—
5827708
AETNA
WA
Enumeration date
08/04/2005
Last updated
09/22/2010
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